(1) Any person who knowingly and willfully executes, or attempts to execute, a scheme or artifice:
(A) To defraud the Workers' Compensation Fund, private carrier or a self-insured employer in connection with the delivery of or payment for workers' compensation health care benefits, items or services;
(B) To obtain, by means of false or fraudulent pretenses, representations, or promises any of the money or property owned by or under the custody or control of the Workers' Compensation Fund, private carrier or a self-insured employer in connection with the delivery of or payment for workers' compensation health care benefits, items or services; or
(C) To make any charge or charges against any injured employee or any other person, firm or corporation which would result in a total charge for the treatment or service rendered in excess of the maximum amount set forth in the Workers' Compensation Commission's schedule of maximum reasonable amounts to be paid for the treatment or services issued pursuant to subsection (a), section three article four, chapter twenty-three of this code is guilty of a felony and, upon conviction thereof, shall be imprisoned in a state correctional facility not less than one year nor more than ten years or, in the discretion of the court, be confined in a county or regional jail not more than one year and shall be fined not more than $2,500.
(2) Any person who, in any matter involving a health care program related to workers' compensation insurance, knowingly and willfully:
(A) Falsifies, conceals or covers up by any trick, scheme or device a material fact; or
(B) Makes any materially false, fictitious or fraudulent statement or representation, or makes or uses any materially false writing or document knowing the same to contain any materially false, fictitious or fraudulent statement or entry, is guilty of a felony and, upon conviction thereof, shall be confined in a state correctional facility for a definite term of imprisonment which is not less than one year nor more than three years or fined not less than $1,000 nor more than $10,000, or both, in the discretion of the court.
(3) Any person who willfully embezzles, steals or otherwise unlawfully converts to the use of any person other than the rightful owner, or intentionally misapplies any of the moneys, funds, securities, premiums, credits, property or other assets of a health care program related to the provision of workers' compensation insurance, is guilty of a felony and, upon conviction thereof, shall be imprisoned in a state correctional facility for not less than one year nor more than ten years or fined not less than $10,000, or both, in the discretion of the court.
(4) Any health care provider who fails, in violation of subsection (5) of this section to post a notice, in the form required by the Workers' Compensation Commission, in the provider's public waiting area that the provider cannot accept any patient whose treatment or other services or supplies would ordinarily be paid for from the Workers' Compensation Fund, private carrier or by a self-insured employer unless the patient consents, in writing, prior to the provision of the treatment or other services or supplies, to make payment for that treatment or other services or supplies himself or herself, is guilty of a misdemeanor and, upon conviction thereof, shall be fined $1,000.
(5) Any person convicted under the provisions of this section shall, after such conviction, be barred from providing future services or supplies to injured employees for the purposes of Workers' Compensation and shall cease to receive payment for services or supplies. In addition to any other penalty imposed, the court shall order any defendant convicted under this section to make full restitution of all moneys paid by or due to the Workers' Compensation Fund, private carrier or self-insured employer as the result of a violation of this section. The restitution ordered shall constitute a judgment against the defendant and in favor of the State of West Virginia Workers' Compensation Commission, Insurance Commissioner, private carrier or self-insured employer.
(6)(A) The court, in imposing sentence on a person convicted of an offense under this section, shall order the person to forfeit property, real or personal, that constitutes or is derived, directly or indirectly, from gross proceeds traceable to the commission of the offense. Any person convicted under this section shall pay the costs of asset forfeiture.
(B) For purposes of subdivision (A) of this subsection, the term "payment of the costs of asset forfeiture" means:
(i) The payment of any expenses necessary to seize, detain, inventory, safeguard, maintain, advertise, sell or dispose of property under seizure, detention or forfeiture, or of any other necessary expenses incident to the seizure, detention, forfeiture or disposal of the property, including payment for:
(I) Contract services;
(II) The employment of outside contractors to operate and manage properties or provide other specialized services necessary to dispose of the properties in an effort to maximize the return from the properties; and
(III) Reimbursement of any state or local agency for any expenditures made to perform the functions described in this subparagraph;
(ii) The compromise and payment of valid liens and mortgages against property that has been forfeited, subject to the discretion of the Workers' Compensation Fund to determine the validity of the lien or mortgage and the amount of payment to be made, and the employment of attorneys and other personnel skilled in state real estate law as necessary;
(iii) Payment authorized in connection with remission or mitigation procedures relating to property forfeited; and
(iv) The payment of state and local property taxes on forfeited real property that accrued between the date of the violation giving rise to the forfeiture and the date of the forfeiture order.
(7) Venue for prosecution of any violation of this section shall be either the county in which the defendant's principal business operations are located or in Kanawha County where the Workers' Compensation Fund is located.
Structure West Virginia Code
Chapter 61. Crimes and Their Punishment
Article 3. Crimes Against Property
§61-3-1. Burning, etc., of a Dwelling or Outbuilding; First Degree Arson; Penalty; Definitions
§61-3-2. Burning, etc., of Other Buildings or Structures; Second Degree Arson; Penalty
§61-3-4. Attempt to Commit Arson; Fourth Degree Arson; Penalty
§61-3-5. Burning, or Attempting to Burn, Insured Property; Penalty
§61-3-6. Willfully, Unlawfully and Maliciously Setting Fire on Lands; Penalty
§61-3-7. Causing Injuries During an Arson-Related Crime; Penalties
§61-3-8. Recovery of Costs Incurred in Fighting Fires Caused by Arson
§61-3-11. Burglary; Entry of Dwelling or Outhouse; Penalties
§61-3-13. Grand and Petit Larceny Distinguished; Penalties
§61-3-14. Larceny of Bank Notes, Checks, Writings of Value and Book Accounts; Penalty
§61-3-15. How Value of Notes, Book Accounts and Other Writings Determined
§61-3-16. Larceny of Things Savoring of Realty
§61-3-18. Receiving or Transferring Stolen Goods
§61-3-20a. Embezzlement by Misuse of Power of Attorney or Other Fiduciary Relationship; Penalty
§61-3-21. Embezzlement by Carrier or Other Person
§61-3-22. Falsifying Accounts; Penalty
§61-3-22a. Possession or Use of Automated Sales Suppression Devices; Penalty
§61-3-23. Destroying or Concealing Will; Embezzlement by Fiduciary; Penalty
§61-3-24c. Intercepting or Monitoring Customer Telephone Calls; Penalty
§61-3-24d. Fraudulent Schemes; Cumulation of Amounts Where Common Scheme Exists; Penalties
§61-3-24f. Wrongfully Seeking Workers' Compensation; False Testimony or Statements; Penalties; Venue
§61-3-25. Casting Away, Destroying or Interfering With Floating Craft or Material; Penalty
§61-3-27. Malicious Killing of Animals by Poison or Otherwise; Penalty
§61-3-28. Offenses Against Railroad Property and Persons on Railroad Property; Definitions
§61-3-33. Entry Upon Inclosed Lands; Penalty; Liability for Damages
§61-3-34. Taking or Injuring Garden or Field Crops; Penalties
§61-3-35. Digging Cultivated Ginseng; Penalty
§61-3-36. Anchoring or Beaching Shanty Boats on Lands of Another; Penalties
§61-3-37. False Statement as to Financial Condition of Person, Firm or Corporation; Penalty
§61-3-38. Publication of False Advertisements; Penalty
§61-3-39. Obtaining Property in Return for Worthless Check; Penalty
§61-3-39a. Making, Issuing, etc., Worthless Checks on a Preexisting Debt; Penalty
§61-3-39c. Reason for Dishonor; Duty of Drawee
§61-3-39d. Prima Facie Evidence of Knowledge; Identity; Penalty for Providing False Information
§61-3-39e. Notice of Dishonor by Payee; Service Charge
§61-3-39f. Manner of Filing Complaint for Warrant; Form
§61-3-39g. Complaint; Notice of Complaint; Issuance of Warrant; Payment Procedures; Costs
§61-3-39h. Payment of Costs in Worthless Check Cases; Disposition of Certain Costs
§61-3-39i. Preparation of List of Worthless Check Warrants
§61-3-39j. Use of Worthless Check List Upon Receipt of Complaint for Warrant
§61-3-39n. Notice to Persons Accepted to the Worthless Check Restitution Program
§61-3-39o. Agreement to Suspend Prosecution of a Person Accepted Into the Restitution Program
§61-3-39p. Fees for Participation in the Worthless Check Restitution Program
§61-3-40. Fraudulently Obtaining Food or Lodging; Penalty
§61-3-41. Employees Conservators of the Peace; Special Railroad Policemen; Penalties
§61-3-42. Intoxication of Person in Charge of Locomotive Engine or Car; Penalties
§61-3-44. Procuring Gas, Water or Electricity, by Device, With Intent to Defraud; Penalty
§61-3-45. Tampering With Pipes, Tubes, Wires or Electrical Conductors; Penalty
§61-3-45a. Unlawful Opening of Pipes, Pipelines, Tanks, etc.; Penalties
§61-3-46. Use of Slugs, False Coins, etc., in Coin-Box Telephone; Penalty
§61-3-47. Dams or Obstructions in Watercourses; Penalty
§61-3-49b. Disruption of Communications and Utilities Services
§61-3-51. Precious Metals and Gem Dealers; Records; Prohibited Acts
§61-3-52. Wrongful Injuries to Timber; Criminal Penalties
§61-3-53. Unauthorized Use of Dumpsters
§61-3-54. Taking Identity of Another Person; Penalty
§61-3-55. Failure to Pay for Gasoline
§61-3-56. Scanning Device or Reencoder Fraud; Felony; Definitions; and Penalties
§61-3-57. Possession of Bogus Receipts or Universal Product Codes With Intent to Defraud; Penalties