North Carolina General Statutes
Article 2 - Programs of Public Assistance.
§ 108A-64 - Medical assistance recipient fraud.

108A-64. Medical assistance recipient fraud.
(a) It shall be unlawful for any person to knowingly and willfully and with intent to defraud make or cause to be made a false statement or representation of a material fact in an application for assistance under this Part, or intended for use in determining entitlement to such assistance.
(b) It shall be unlawful for any applicant, recipient or person acting on behalf of such applicant or recipient to knowingly and willfully and with intent to defraud, conceal or fail to disclose any condition, fact or event affecting such applicant's or recipient's initial or continued entitlement to receive assistance under this Part.
(b1) It is unlawful for any person knowingly, willingly, and with intent to defraud, to obtain or attempt to obtain, or to assist, aid, or abet another person, either directly or indirectly, to obtain money, services, or any other thing of value to which the person is not entitled as a recipient under this Part, or otherwise to deliberately misuse a Medicaid identification card. This misuse includes the sale, alteration, or lending of the Medicaid identification card to others for services and the use of the card by someone other than the recipient to receive or attempt to receive Medicaid program coverage for services rendered to that individual.
Proof of intent to defraud does not require proof of intent to defraud any particular person.
(c) (1) A person who violates a provision of this section shall be guilty of a Class I felony if the value of the assistance wrongfully obtained is more than four hundred dollars ($400.00).
(2) A person who violates a provision of this section shall be guilty of a Class 1 misdemeanor if the value of the assistance wrongfully obtained is four hundred dollars ($400.00) or less.
(d) For purposes of this section the word "person" includes any natural person, association, consortium, corporation, body politic, partnership, or other group, entity or organization. (1981, c. 275, s. 1; 1993, c. 539, s. 817; 1994, Ex. Sess., c. 24, s. 14(c); 1995, c. 317, s. 1.)

Structure North Carolina General Statutes

North Carolina General Statutes

Chapter 108A - Social Services

Article 2 - Programs of Public Assistance.

§ 108A-24 - Definitions.

§ 108A-25 - Creation of programs; assumption by federally recognized tribe of programs.

§ 108A-25.1A - Responsibility for errors.

§ 108A-25.2 - Exemption from limitations for individuals convicted of certain drug-related felonies.

§ 108A-25.3 - Garnishment of wages to recoup fraudulent public assistance program payment.

§ 108A-25.4 - Use of payments under the Low-Income Energy Assistance Program and Crisis Intervention Program.

§ 108A-26 - Certain financial assistance and in-kind goods not considered in determining assistance paid under Chapters 108A and 111.

§ 108A-26.1 - Information sharing of outstanding arrest warrant of applicant for or recipient of program assistance.

§ 108A-26.2 - Fleeing felon or parole or probation violator; eligibility for program assistance; federal approval; review by department.

§ 108A-26.5 - NC FAST caseworker training and certification program.

§ 108A-27 - (See editor's note) Authorization and description of Work First Program; Work First Program changes; designation of Electing and Standard Program Counties.

§ 108A-27.01 - Income eligibility and payment level for Work First Family Assistance.

§ 108A-27.1 - Time limitations on assistance.

§ 108A-27.2 - General duties of the Department.

§ 108A-27.3 - Electing Counties - Duties of county boards of commissioners.

§ 108A-27.4 - Electing Counties - County Plan.

§ 108A-27.5 - Electing Counties - Duties of the Department.

§ 108A-27.6 - Standard Program Counties - Duties of county departments of social services and county boards of commissioners.

§ 108A-27.7 - Standard Program County Plan.

§ 108A-27.8 - Standard Program Counties - Duties of Department.

§ 108A-27.9 - State Plan.

§ 108A-27.10 - Duties of the Director of the Budget/Governor.

§ 108A-27.11 - Work First Program funding.

§ 108A-27.12 - Maintenance of effort.

§ 108A-27.13 - Performance standards.

§ 108A-27.14 - Corrective action.

§ 108A-27.15 - Assistance not an entitlement; appeals.

§ 108A-29 - Priority for employment services.

§ 108A-29.1 - Drug screening and testing for Work First Program applicants and recipients.

§ 108A-31 - Application for assistance.

§ 108A-36 - Assistance not assignable; checks payable to decedents.

§ 108A-37 - Personal representative for mismanaged public assistance.

§ 108A-38 - Protective and vendor payments.

§ 108A-39 - Fraudulent misrepresentation.

§ 108A-40 - (Effective until contingency met see note) Authorization of State-County Special Assistance Program.

§ 108A-41 - (Effective until contingency met see note) Eligibility.

§ 108A-42 - Determination of disability.

§ 108A-42.1 - (Effective once contingency met see note) State-County Special Assistance Program payment rates.

§ 108A-43 - Application procedure.

§ 108A-44 - State funds to counties.

§ 108A-45 - Participation.

§ 108A-46.1 - Transfer of assets for purposes of qualifying for State-county Special Assistance.

§ 108A-47 - Limitations on payments.

§ 108A-48 - State Foster Care Benefits Program.

§ 108A-49 - Foster care and adoption assistance payments.

§ 108A-49.1 - Foster care and adoption assistance payment rates.

§ 108A-50 - State benefits for certain adoptive children.

§ 108A-50.1 - Special Needs Adoptions Incentive Fund.

§ 108A-50.2 - Adoption Promotion Fund.

§ 108A-51 - Authorization for Food and Nutrition Services.

§ 108A-51.1 - Prohibition on certain waivers.

§ 108A-52 - Determination of eligibility.

§ 108A-53 - Fraudulent misrepresentation.

§ 108A-53.1 - Illegal possession or use of electronic food and nutrition benefits.

§ 108A-54 - (Effective until contingency met see note) Authorization of Medical Assistance Program; administration.

§ 108A-54.1 - Recodified as G.S108A-66.1 by Session Laws 2013-360, s12H.10(f), effective July 1, 2013.

§ 108A-54.1A - (Effective until contingency met see note) Amendments to Medicaid State Plan and Medicaid Waivers.

§ 108A-54.1B - Adoption of rules; State Plans, including amendments and waivers to State Plans, have effect of rules.

§ 108A-54.2 - (Effective until contingency met see note) Procedures for changing medical policy.

§ 108A-54.3A - Eligibility categories and income thresholds.

§ 108A-54.4 - Income disregard for federal cost-of-living adjustments.

§ 108A-54.5 - Maintenance of waivers for dependents of members of Armed Forces.

§ 108A-55 - Payments.

§ 108A-55.1 - Medicare enrollment required.

§ 108A-55.2 - Collaboration among agencies to ensure Medicaid-related services payments to eligible students with disabilities in public schools.

§ 108A-55.3 - Verification of State residency required for medical assistance.

§ 108A-55.4 - Insurers to provide certain information to Department of Health and Human Services.

§ 108A-55.5 - Eligibility monitoring for medical assistance.

§ 108A-56 - Acceptance of federal grants.

§ 108A-57 - (Effective until contingency met see note) Subrogation rights; withholding of information a misdemeanor.

§ 108A-57.1 - Rules governing transfer of medical assistance benefits between counties.

§ 108A-58.1 - Ineligibility for medical assistance based on transferring assets for less than fair market value.

§ 108A-58.2 - Waiver of transfer of assets penalty due to undue hardship.

§ 108A-59 - Acceptance of medical assistance constitutes assignment to the State of right to third party benefits; recovery procedure.

§ 108A-60 - Protection of patient property.

§ 108A-61.1 - Financial responsibility of a parent for a child under age 21 in a medical institution.

§ 108A-62 - Therapeutic leave for medical assistance patients.

§ 108A-63 - Medical assistance provider fraud.

§ 108A-63.1 - Health care fraud subpoena to produce documents.

§ 108A-64 - Medical assistance recipient fraud.

§ 108A-64.1 - Incentives to counties to recover fraudulent Medicaid expenditures.

§ 108A-65 - Conflict of interest.

§ 108A-66.1 - Medicaid buy-in for workers with disabilities.

§ 108A-67 - Medicare/Qualified Disabled Working Individuals.

§ 108A-68 - Drug Use Review Program; rules.

§ 108A-68.1 - Certain prescription drugs exempt from prior authorization requirements.

§ 108A-68.2 - (Effective until contingency met see note) Beneficiary lock-in program for certain controlled substances.

§ 108A-69 - Employer obligations.

§ 108A-70 - Recoupment of amounts spent on medical care.

§ 108A-70.4 - Long-Term Care Partnership Program.

§ 108A-70.5 - Medicaid Estate Recovery Plan.

§ 108A-70.9A - (Effective until contingency met see note) Definitions; Medicaid recipient appeals.

§ 108A-70.9B - (Effective until contingency met see note) Contested Medicaid cases.

§ 108A-70.9C - Informal review permitted.

§ 108A-70.10 - Short title.

§ 108A-70.11 - Definitions.

§ 108A-70.12 - Liability for certain acts; damages; effect of repayment.

§ 108A-70.13 - False claims procedure.

§ 108A-70.14 - Civil investigative demand.

§ 108A-70.15 - Employee remedies.

§ 108A-70.16 - Uniformity of interpretation.

§ 108A-70.30 - Recodified as Part 33 of Article 7 of Chapter 143B, G.S143B-344.46, by Session Laws 2013-360, s15.22(h), effective July 1, 2013.

§ 108A-70.36 - Applicability.

§ 108A-70.37 - Timely decision standards.

§ 108A-70.38 - Timely processing standards.

§ 108A-70.39 - Average processing time standards.

§ 108A-70.40 - Percentage processed timely standards.

§ 108A-70.41 - Corrective action.

§ 108A-70.42 - Temporary assumption of Medicaid eligibility administration.

§ 108A-70.43 - (Effective until contingency met see note) Reporting.

§ 108A-70.45 - Applicability.

§ 108A-70.46 - Audit of county Medicaid determinations.

§ 108A-70.47 - Medicaid eligibility determination processing accuracy standards.

§ 108A-70.48 - Quality assurance.

§ 108A-70.49 - Corrective action.

§ 108A-70.50 - Temporary assumption of Medicaid eligibility administration.

§ 108A-70.51 - (Effective until contingency met see note) Reporting.