(a) A person commits the offense of medical assistance fraud if:

Attorney's Note

Under the Hawaii Revised Statutes, punishments for crimes depend on the classification. In the case of this section:
ClassPrisonFine
Class C felonyup to 5 yearsup to $10,000
For details, see Haw. Rev. Stat. § 706-660
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Terms Used In Hawaii Revised Statutes 346-43.5

  • Fraud: Intentional deception resulting in injury to another.
  • Medical assistance: means payment for medical care or personal care services, including funds received from the federal government. See Hawaii Revised Statutes 346-1
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
(1) The person knowingly makes or causes to be made to the medical assistance program any false statement or representation of a material fact in any application for any benefit or payment for furnishing services or supplies, or for the purpose of obtaining greater compensation than that to which the person is legally entitled, or for the purpose of obtaining authorization for furnishing services or supplies; or
(2) The person knowingly makes or causes to be made any false statement or representation of a material fact in any application for any medical assistance benefit or renewal of any medical assistance benefit, or in any statement, document, or record, in written, printed, or electronic form, in support of, or connected with, that application for or renewal of medical assistance benefits.
(b) A person convicted under subsection (a)(2) shall pay restitution equivalent to the amount of medical assistance benefits paid by the State on behalf of that person.
(c) For purposes of this section, the term “medical assistance benefit” means health care coverage or services, including medical, behavioral health, dental, or long-term care services, provided to or paid for on behalf of a person by the State, regardless of source of funding. Payment for medical assistance benefits may be made through capitated payments, insurance premiums, copayments, any payments made by the State to that person’s health care providers, and any other payments made by the State on behalf of the person for health care coverage or services.
(d) The offense of medical assistance fraud is a class C felony.
(e) The remedies provided under this section are not exclusive and shall not preclude the use of any other criminal or civil remedy.

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