Illinois Strengthens Penalties for Healthcare Fraud

On August 16, 2013, Governor Pat Quinn signed legislation that strengthen criminal and civil penalties relating to Medicaid fraud, combining those penalties with already significant state and federal criminal penalties, civil penalties, and potential exclusion from healthcare programs funded by the government. 

Under the new legislation (Public Act 098-0354), the Illinois Department of Healthcare and Family Services is authorized to increase the penalty for making false statements relating to a federal or state healthcare program from a misdemeanor to a felony. Under the new law, violations are class 4 felonies that can be punished by one to three years in prison and fines of up to $25,000 for individuals and $50,000 for corporations. The same law also added definitions of Medicaid fraud to those that already existed. Medicaid fraud is punishable as a felony under state law as well, if the conduct causes sufficient damage to the state. The Illinois Department of Healthcare and Family Services referred 38 cases of fraud to prosecutors and terminated 144 providers in 2012.

In addition to the increased state penalties, there are a number of existing criminal statutes available to federal prosecutors for the pursuit of healthcare fraud, including the healthcare fraud, mail fraud, wire fraud and anti-kickback statutes.