Description
The crime of Medi-Cal Fraud is to knowingly make or cause to be made any false or fraudulent claim for payment of a Medi-Cal benefit, or knowingly submit a claim for a Medi-Cal benefit that was not used by the claimant. Medi-Cal Fraud crime may also be prosecuted under general Insurance Fraud, or the Welfare & Institutions Code § 14014 as felony for fraud over $950 or as a misdemeanor for fraud less than $950. Sentence enhancements may be applied under certain circumstances, such as the fraud resulting in bodily injury.
What does the prosecutor have to prove?
1. Defendant knowingly presented or caused to be presented a false or fraudulent claim for payment of a loss or injury, including payment of a loss or injury under a contract of insurance. or
1. Defendant aided and abetted in presenting or causing to be presented a false or fraudulent claim for payment of a loss or injury, including payment of a loss or injury under a contract of insurance. or
1. Defendant conspired to present or cause to be presented a false or fraudulent claim for payment of a loss or injury, including payment of a loss or injury under a contract of insurance.
2. Defendant did so with the specific intent to defraud.
Punishment
Felony: 2years/3years/5years
With probation 0-364 days