A person who knowingly causes to be presented a false claim for payment to an insurer transacting business in this State, to a health maintenance organization transacting business in this State, or to any person, including the State of South Carolina, providing benefits for health care in this State, whether these benefits are administered directly or through a third person, or who knowingly assists, solicits, or conspires with another to present a false claim for payment as described above, is guilty of a:
(1) felony if the amount of the claim is ten thousand dollars or more. Upon conviction, the person must be imprisoned not more than ten years or fined not more than five thousand dollars, or both;
(2) felony if the amount of the claim is more than two thousand dollars but less than ten thousand dollars. Upon conviction, the person must be fined in the discretion of the court or imprisoned not more than five years, or both;
(3) misdemeanor triable in magistrates court or municipal court, notwithstanding the provisions of Sections 22-3-540, 22-3-545, 22-3-550, and 14-25-65, if the amount of the claim is two thousand dollars or less. Upon conviction, the person must be fined not more than one thousand dollars, or imprisoned not more than thirty days, or both.
HISTORY: Former 1976 Code Section 38-55-170 [1962 Code Section 37-1217; 1964 (53) 2293] recodified as Section 38-57-170 by 1987 Act No. 155, Section 1; Former 1976 Code Section 38-9-310 [1947 (45) 322; 1952 Code Section 37-167; 1962 Code Section 37-167; 1986 Act No. 410] recodified as Section 38-55-170 by 1987 Act No. 155, Section 1; 1989 Act No. 148, Section 23; 1993 Act No. 73, Section 1; 1993 Act No. 184, Section 121; 2010 Act No. 273, Section 16.Z, eff June 2, 2010.
Structure South Carolina Code of Laws
Chapter 55 - Conduct Of Insurance Business
Section 38-55-10. No contracts may be made except under this title.
Section 38-55-20. Insurers shall do business in own name; combination policy.
Section 38-55-30. Limitation of risk; section not applicable to captive insurers.
Section 38-55-40. Certain inducements may not be offered.
Section 38-55-50. Discrimination prohibited.
Section 38-55-60. Punishment and revocation of license for discrimination.
Section 38-55-70. Secured loans lawful.
Section 38-55-75. Confidentiality of information received by Department of Insurance.
Section 38-55-80. Loans to directors or officers.
Section 38-55-90. Tontine policies prohibited.
Section 38-55-100. Tontine plans prior to May 12, 1947.
Section 38-55-110. Reserve requirements for tontine policies.
Section 38-55-120. Procedure when insurer fails to pay final judgment.
Section 38-55-130. Doing business after charter has been canceled or surrendered is unlawful.
Section 38-55-150. Accepting premiums or assessments in insolvent insurer.
Section 38-55-160. Insuring uninsurable persons with intent to defraud.
Section 38-55-170. Presenting false claims for payment.
Section 38-55-173. Unlawful vehicle glass repair business practices; penalties.
Section 38-55-310. Life insurers may not operate undertaking business.
Section 38-55-320. Insurers may not contract with undertakers for funerals.
Section 38-55-330. Funeral director may act as agent for life insurer for preneed funeral contract.
Section 38-55-510. Short title.
Section 38-55-520. Purpose of article.
Section 38-55-530. Definitions.