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Synopsis As Introduced Amends the Public Assistance Fraud Article of the Illinois Public Aid Code. Provides that (i) any person who knowingly obtains unauthorized medical benefits or causes to be obtained unauthorized medical benefits (rather than knowingly obtains unauthorized medical benefits) with or without use of a medical card; (ii) any vendor that knowingly assists or knowingly or willfully fails to prevent a person from committing specified violations; or (iii) any person (including a vendor, organization, agency, or other entity) that, in any matter related to the medical assistance program, knowingly or willfully falsifies, conceals, or omits by any trick, scheme, artifice, or device a material fact, or makes any false, fictitious, or fraudulent statement or representation, or makes or uses any false writing or document, knowing the same to contain any false, fictitious, or fraudulent statement or entry in connection with the provision of health care or related services commits medical assistance fraud. Sets forth conduct that constitutes managed health care fraud. Enhances the criminal penalty, from a Class A misdemeanor to a Class 4 felony, for any person, firm, corporation, association, agency, institution, or other legal entity that, in any matter related to a State or federally funded or mandated health plan, knowingly and willfully makes a false statement in connection with the provision of health care or related services. Provides that no person shall willfully obstruct criminal investigations of health care offenses and makes a violation a Class 4 felony. Effective immediately.
Replaces everything after the enacting clause. Reinserts the provisions of the bill as introduced, with the following changes: Provides that any vendor that knowingly assists a person (rather than any vendor that knowingly assists or knowingly or willfully fails to prevent a person) in committing specified violations concerning the unauthorized use of a medical card or the unauthorized use of medical benefits with or without a medical card commits medical assistance fraud. Provides that the term "knowledge" has the meaning ascribed to that term in the Criminal Code of 2012 when used in the context of certain violations of medical assistance fraud. Does not include provisions creating the offense of obstruction of criminal investigations of health care offenses. Makes other changes. Effective immediately.
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