(A)(1) It is unlawful for a person to knowingly and wilfully to make or cause to be made a false statement or representation of material fact on an application for assistance, goods, or services under the state’s Medicaid program when the false statement or representation is made for the purpose of determining the person’s entitlement to assistance, goods, or services.

(2) It is unlawful for any applicant, recipient, or other person acting on behalf of the applicant or recipient knowingly and wilfully to conceal or fail to disclose any material fact affecting the applicant’s or recipient’s initial or continued entitlement to receive assistance, goods, or services under the state’s Medicaid program.

Attorney's Note

Under the South Carolina Code, punishments for crimes depend on the classification. In the case of this section:
ClassPrisonFine
Class A misdemeanorup to 3 years
For details, see § 16-1-20

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Terms Used In South Carolina Code 43-7-70

  • Conviction: A judgement of guilt against a criminal defendant.
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • Fraud: Intentional deception resulting in injury to another.
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC

(3) It is unlawful for a person eligible to receive benefits, services, or goods under the Medicaid program to sell, lease, lend, or otherwise exchange rights, privileges, or benefits to another person.

(B) A person who violates the provisions of this section is guilty of medical assistance recipient fraud, a Class A misdemeanor and, upon conviction, must be imprisoned not more than three years or fined not more than one thousand dollars, or both.