Bill Text: CT SB01165 | 2011 | General Assembly | Comm Sub
Bill Title: An Act Concerning Medicare And Medicaid Fraud.
Spectrum: Committee Bill
Status: (Introduced - Dead) 2011-05-24 - Favorable Report, Tabled for the Calendar, Senate [SB01165 Detail]
Download: Connecticut-2011-SB01165-Comm_Sub.html
General Assembly |
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January Session, 2011 |
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AN ACT CONCERNING MEDICARE AND MEDICAID FRAUD.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. (NEW) (Effective October 1, 2011) (a) For the purposes of this section:
(1) "Medicare or Medicaid fraud" means a crime involving fraud in the Medicare program or the Medicaid program, including, but not limited to, vendor fraud, as defined in section 53a-290 of the general statutes, related to the Medicare program or the Medicaid program;
(2) "Person" means "person", as defined in section 53a-3 of the general statutes; and
(3) "This state" includes the land and water, and the air space above such land and water, with respect to which the General Assembly has jurisdiction to enact legislation.
(b) With respect to Medicare or Medicaid fraud, a person shall be criminally liable as provided in section 53a-11 of the general statutes or section 2 of this act, or shall be criminally liable for conduct performed in such person's own name or on such person's behalf, if:
(1) (A) The conduct which is an element of the Medicare or Medicaid fraud occurs within this state, or (B) the result which is an element of the Medicare or Medicaid fraud occurs within this state, except that this subparagraph shall not apply when the result within this state is caused by conduct occurring outside this state which would not constitute Medicare or Medicaid fraud where the conduct occurred, unless the person intentionally or knowingly caused the Medicare or Medicaid fraud within this state;
(2) Conduct occurring outside this state is sufficient under the laws of this state to constitute an attempt to commit Medicare or Medicaid fraud within this state;
(3) Conduct occurring outside this state is sufficient under the laws of this state to constitute conspiracy to commit Medicare or Medicaid fraud within this state, and an overt act in pursuance of such conspiracy occurs within this state;
(4) Conduct occurring within this state establishes the element under subsection (a) of section 53a-8 of the general statutes of soliciting, requesting, commanding, importuning or intentionally aiding another person to engage in conduct which constitutes Medicare or Medicaid fraud in another jurisdiction and which is also a crime in this state;
(5) The Medicare or Medicaid fraud consists of the omission to perform a duty imposed by the laws of this state with respect to domicile in this state, residence in this state, or the relationship to a person, thing or transaction in this state; or
(6) The Medicare or Medicaid fraud is based on a provision of the general statutes which expressly prohibits conduct outside this state when such conduct bears a reasonable relationship to a legitimate interest of this state and the person knew or should have known that the person's conduct was likely to affect such interest of this state.
Sec. 2. (NEW) (Effective October 1, 2011) (a) As used in this section:
(1) "Agent" means a director, officer, employee or other person authorized to act on behalf of a corporation, a member of an unincorporated association or a partner in a partnership;
(2) "Corporation" means a public or private corporation, a limited liability company, an unincorporated association or a partnership. "Corporation" does not include a government or a governmental instrumentality;
(3) "High managerial agent" means an agent of a corporation having duties of such responsibility that the agent's conduct may fairly be assumed to represent the policy of the corporation; and
(4) "Medicare or Medicaid fraud" means a crime involving fraud in the Medicare program or the Medicaid program, including, but not limited to, vendor fraud, as defined in section 53a-290 of the general statutes, provided such vendor fraud is related to the Medicare program or Medicaid program.
(b) A corporation may be convicted of Medicare or Medicaid fraud if:
(1) The crime is established in the general statutes and consists of Medicare or Medicaid fraud and (A) the court determines that the legislative intent of the crime is to impose liability on a corporation for Medicare or Medicaid fraud, or (B) the statute designates the agents for whose conduct the corporation is accountable or the circumstances under which the corporation is accountable;
(2) The Medicare or Medicaid fraud is performed by an agent of the corporation on behalf of the corporation, within the scope of the agent's office or employment;
(3) The commission of the Medicare or Medicaid fraud consists of an omission to discharge a specific duty to perform imposed on the corporation by law; or
(4) The commission of the Medicare or Medicaid fraud was authorized, requested, commanded, performed or recklessly tolerated by the board of directors of the corporation, or by a high managerial agent acting on behalf of the corporation within the scope of the high managerial agent's office or employment.
(c) Whenever a duty to act is imposed by law on a corporation with respect to Medicare or Medicaid fraud, any agent of the corporation having primary responsibility for the discharge of such duty shall be criminally liable for a reckless omission to act to the same extent as if such duty were imposed by law directly on such agent.
(d) In any prosecution under this section, it shall be an affirmative defense that the defendant exercised due diligence to prevent the commission of the crime.
(e) Any agent, high managerial agent or corporation convicted of Medicare or Medicaid fraud pursuant to this section shall be subject to the penalty applicable when an individual commits such Medicare or Medicaid fraud in such individual's capacity.
This act shall take effect as follows and shall amend the following sections: | ||
Section 1 |
October 1, 2011 |
New section |
Sec. 2 |
October 1, 2011 |
New section |
JUD |
Joint Favorable Subst. |
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HS |
Joint Favorable |