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Can you summarize SCCL 38-55-170?
General Provisions > Presenting false claims for payment.
Short Summary
This provision of the South Carolina Code of Laws governs the act of knowingly presenting false claims for payment to insurers, health maintenance organizations, or any person providing healthcare benefits in South Carolina. It applies to any person who engages in such fraudulent activities. The penalties for this offense vary based on the amount of the false claim. If the claim is $10,000 or more, it is considered a felony punishable by imprisonment for up to 10 years, a fine of up to $5,000, or both. If the claim is more than $2,000 but less than $10,000, it is also a felony, and the person may be fined at the discretion of the court or imprisoned for up to 5 years, or both. If the claim is $2,000 or less, it is considered a misdemeanor triable in magistrates court or municipal court, and the person may be fined up to $1,000, imprisoned for up to 30 days, or both.
Whom does it apply to?
Any person who knowingly causes to be presented a false claim for payment to an insurer transacting business in South Carolina, a health maintenance organization transacting business in South Carolina, or any person providing benefits for healthcare in South Carolina
What does it govern?
Presenting false claims for payment
What are exemptions?
No exemptions are mentioned.
What are the Penalties?
1) Felony: If the amount of the false claim is $10,000 or more, the person may be imprisoned for up to 10 years, fined up to $5,000, or both. 2) Felony: If the amount of the false claim is more than $2,000 but less than $10,000, the person may be fined at the discretion of the court or imprisoned for up to 5 years, or both. 3) Misdemeanor: If the amount of the false claim is $2,000 or less, the person may be fined up to $1,000, imprisoned for up to 30 days, or both.
Jurisdiction
South Carolina