Title 50 — Public Welfare

As used in this chapter, unless the context otherwise requires: 1. "Benefit" means the provision of anything of pecuniary value under the Medicaid program. 2. "Claim" means: a. Any request or demand, whether under a contract or otherwise, for money or property under the Medicaid …

1. Except as provided in subsections 2 and 3, a person is liable to the state for a civil penalty of not less than one thousand dollars and not more than ten thousand dollars for each act specified in this section, three times the amount of damages the state sustains because of t…

1. A civil action filed under this chapter must be brought by the later of: a. Six years after the date on which the violation was committed; or b. Three years after the date facts material to the right of action are known or reasonably should have been known by the official of t…

The attorney general's Medicaid fraud control unit shall investigate an alleged violation of this chapter and may file a civil action, a criminal action, or both against any person that violated or is violating this chapter.

The standard of proof in a civil action brought under this chapter is the preponderance of the evidence.

A defendant convicted in any criminal proceeding under this chapter is precluded from subsequently denying the essential elements of the criminal offense of which the defendant was convicted in any civil proceeding. For purposes of this section, a conviction may result from a ver…

If the state favorably settles or prevails in a civil action in which the state intervened or filed, the state is entitled to be awarded reasonable expenses, consultant and expert witness fees, costs, and attorney's fees. In an action in which outside counsel is engaged by the at…

1. An employee, contractor, or agent is entitled to all relief necessary to make that employee, contractor, or agent whole, if that employee, contractor, or agent is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms an…

The Medicaid fraud control unit is established as a division of the attorney general's office. The Medicaid fraud control unit, which is under the supervision and control of the attorney general, consists of the agents and employees the attorney general considers necessary and ap…

1. The Medicaid fraud control unit shall: a. Investigate and prosecute under applicable criminal or civil laws fraud and patient abuse or neglect by providers or any other person, including cases referred by the department; b. Review complaints of patient abuse, patient neglect, …

1. A person commits a criminal offense under this section if the person knowingly: a. Presents for allowance, for payment, or for the purpose of concealing, avoiding, or decreasing an obligation to pay a false or fraudulent medical assistance claim, bill, account, voucher, or wri…

1. A person that submits a claim for or receives a payment for a good or service under the state's Medicaid program, at the time the good or service is provided, shall create and retain records as required by rule of the department and chapter 50-24.8. 2. A person that submits a …

All local, county, and state departments and agencies shall cooperate with the Medicaid fraud control unit and the unit's agents and employees to effectuate the purposes of the unit.

The attorney general may adopt rules, pursuant to chapter 28-32, to implement this chapter.