§ 25.5-4-305 — False medicaid claims - liability for certain acts

Colorado § 25.5-4-305

• Jurisdiction: Colorado
• Title 25.5: Health
• Art.: Colorado Medical Assistance Act -

Text

(1) Except as
otherwise provided in subsection (2) of this section, a person is liable to the state
for a civil penalty of not less than five thousand five hundred dollars and not more
than eleven thousand dollars; except that these upper and lower limits on liability
shall automatically increase to equal the civil penalty allowed under the federal
False Claims Act, 31 U.S.C. sec. 3729, et seq., if and as the penalties in such
federal act may be adjusted for inflation as described in said act in accordance with
the federal Civil Penalties Inflation Adjustment Act of 1990, Pub. L. No. 101-410,
plus three times the amount of damages that the state sustains because of the act
of that person, if the person:

(a) Knowingly presents, or causes to be presented, a false or fraudulent
claim for payment or approval;

(b) Knowingly makes, uses, or causes to be made or used a false record or
statement material to a false or fraudulent claim;

(c) Has possession, custody, or control of property or money used, or to be
used, by the state in connection with the Colorado Medical Assistance Actand
knowingly delivers, or causes to be delivered, less than all of the money or property;

(d) Authorizes the making or delivery of a document certifying receipt of
property used, or to be used, by the state in connection with the Colorado Medical
Assistance Act and, intending to defraud the state, makes or delivers the receipt
without completely knowing that the information on the receipt is true;

(e) Knowingly buys, or receives as a pledge of an obligation or debt, public
property from an officer or employee of the state in connection with the Colorado
Medical Assistance Act who lawfully may not sell or pledge the property;

(f) Knowingly makes, uses, or causes to be made or used, a false record or
statement material to an obligation to pay or transmit money or property to the
state in connection with the Colorado Medical Assistance Act, or knowingly
conceals or knowingly and improperly avoids or decreases an obligation to pay or
transmit money or property to the state in connection with the Colorado Medical
Assistance Act;

(g) Conspires to commit a violation of paragraphs (a) to (f) of this subsection
(1).

(2) Notwithstanding the amount of damages authorized in subsection (1) of
this section, for a person who violates subsection (1) of this section, the court may
assess not less than twice the amount of damages that the state sustains because
of the act of the person if the court finds that:

(a) The person who committed the violation of subsection (1) of this section
furnished to the officials of the state responsible for investigating false claims
violations all information about the violation known to the person and furnished said
information within thirty days after the date on which the person first obtained the
information;

(b) At the time the person furnished the information about the violation to
the state, a criminal prosecution, civil action, or administrative action had not
commenced with respect to the violation and the person did not have actual
knowledge of the existence of an investigation into the violation; and

(c) The person fully cooperated with any investigation of the violation by the
state.

(3) A person violating this section shall also be liable to the state for the
costs of a civil action brought to recover any penalty or damages.

(4) Any information furnished pursuant to subsection (2) of this section shall
be exempt from disclosure under part 2 of article 72 of this title.

Legislative History

Source: L. 2006: Entire article added with relocations, p. 1839, � 7, effective July 1. L. 2010: Entire section R&RE, (SB 10-167), ch. 296, p. 1380, � 12, effective May 26. L. 2011: IP(1) amended, (HB 11-1303), ch. 264, p. 1168, � 66, effective August 10. L. 2013: IP(1) and (1)(a) amended, (SB 13-205), ch. 276, p. 1441, � 4, effective August 7.