This legal document, found in the United States Code under Crimes and Criminal Procedure, specifically addresses health care fraud. It prohibits any person from knowingly and willfully executing or attempting to execute a scheme or artifice to defraud any health care benefit program or obtain money or property owned by or under the custody or control of any health care benefit program. The document states that a person does not need to have actual knowledge of this section or specific intent to commit a violation.

This document governs referral standards in the context of workers’ compensation medical cost containment. It applies to providers, entities, and insurers involved in referrals for treatment and services. Under section 306(f.1)(3)(iii) of the act, providers are prohibited from referring a person for certain treatment and services if they have a financial interest with the person or the receiving entity. Claim for payment for services furnished under a prohibited referral is not allowed.

This legal document, part of the Montana Code related to insurance and insurance companies, governs the disclosure of information in the event of a computer security breach. It requires any licensee or insurance-support organization conducting business in Montana, and owning or licensing computerized data containing personal information, to provide notice of any breach of the system’s security to individuals whose unencrypted personal information was or is reasonably believed to have been acquired by an unauthorized person.

(1) Unless authorized by the insurer, a treating physician may not refer a claimant to a health care facility at which the physician does not directly provide care or services when the physician has an investment interest in the facility, unless there is a demonstrated need in the community for the facility and alternative financing is not available. The insurer or the claimant is not liable for charges incurred in violation of this section.

This legal document in Montana governs prohibited actions and penalties related to workers’ compensation. It applies to health care providers. The document prohibits health care providers from failing to certify the provision of services or treatment for which compensation is claimed under this chapter, and from referring a worker for treatment or diagnosis of an injury or illness that is compensable under this chapter to a facility owned by the provider without informing the worker of the ownership interest and providing alternate facility options.

The first legal document governs businesses that have an established business relationship with a customer and have disclosed personal information to third parties for direct marketing purposes. It requires businesses to provide certain information to customers upon request, including a list of categories of personal information disclosed and the names and addresses of the third parties who received the information. The second document pertains to the disclosure of security breaches of computerized data containing personal information.

This legal document outlines the prohibited activities and sanctions related to insurance fraud in Louisiana. Any person who commits acts with the intent to injure, defraud, or deceive insurance companies, the Department of Insurance, insured parties, or third-party claimants may be guilty of a felony. The specified acts include committing fraudulent insurance acts, presenting false information in support of a claim, and assisting or conspiring with others to make false statements.

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.

This legal document, known as the South Carolina Insurance Data Security Act, outlines the notification requirements that licensees, including insurers and producers, must follow in the event of a cybersecurity event. Licensees must notify the director within 72 hours of determining that a cybersecurity event has occurred. This requirement applies if South Carolina is the licensee’s state of domicile or home state, or if the licensee reasonably believes that the event involves nonpublic information of at least 250 consumers residing in South Carolina and has a reasonable likelihood of materially harming a consumer or the licensee’s normal operations.

This legal document prohibits attorneys or law firms from consistently referring clients to the same health care provider, and health care providers from consistently referring patients to the same attorney or law firm, in cases of accidental harm subject to benefits under this article. Violation of this section is presumed if such a pattern is established. Additionally, health care providers are prohibited from engaging in fee splitting, referring patients to entities in which they have a financial interest without disclosure, and must obtain written disclosure from patients indicating their freedom to choose a different health care provider.

This part of the Hawaii Revised Statutes governs the administration of insurance laws related to insurance fraud. It establishes the insurance fraud investigations branch within the insurance division, which is responsible for conducting a statewide program for the prevention of insurance fraud, investigating and prosecuting insurance fraud violations, and promoting public and industry-wide education about insurance fraud. The branch has jurisdiction over insurance fraud violations under title 24, excluding workers’ compensation insurance.