Decreases certain amounts of payments wrongfully received that would trigger higher degrees of the crime of health care fraud.

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S1659-2011 Actions

• Jun 21, 2012: referred to codes
• Jun 21, 2012: DELIVERED TO ASSEMBLY
• Jun 21, 2012: PASSED SENATE
• May 21, 2012: ADVANCED TO THIRD READING
• May 16, 2012: 2ND REPORT CAL.
• May 15, 2012: 1ST REPORT CAL.765
• Jan 4, 2012: REFERRED TO CODES
• Jan 11, 2011: REFERRED TO CODES

S1659-2011 Meetings

Codes: Mar 15, 2011, Codes: May 15, 2012

S1659-2011 Calendars

Active List: Jun 21, 2012 , Floor Calendar: May 16, 2012 , Floor Calendar: May 21, 2012 , Floor Calendar: May 22, 2012 , Floor Calendar: May 23, 2012 , Floor Calendar: May 30, 2012 , Floor Calendar: May 31, 2012 , Floor Calendar: Jun 4, 2012 , Floor Calendar: Jun 5, 2012 , Floor Calendar: Jun 6, 2012 , Floor Calendar: Jun 11, 2012 , Floor Calendar: Jun 12, 2012 , Floor Calendar: Jun 13, 2012 , Floor Calendar: Jun 14, 2012 , Floor Calendar: Jun 18, 2012 , Floor Calendar: Jun 19, 2012 , Floor Calendar: Jun 20, 2012 , Floor Calendar: Jun 21, 2012

S1659-2011 Votes

S1659-2011 Memo

BILL NUMBER:S1659

TITLE OF BILL:
An act
to amend the penal law, in relation to health care fraud

PURPOSE:
The purpose of this bill is to decrease the amount of wrongfully
received payments needed to trigger higher statutory criminal
classification.

SUMMARY OF PROVISIONS:
Section 177.10 of the penal law is amended from $3,000 to $1,000.
Section 177.15 of the penal law is amended from $10,000 to $5,000
Section 177.20 of the penal law is amended from $50,000 to $25,000
Section 177.25 of the penal law is amended from $1 million to $500,000

EXISTING LAW:
The current amount of fraud required for health care fraud in the 4th
degree through 1st degree is $3,000; $10,000; $50,000 and $1 million
respectively.

JUSTIFICATION:
The current dollar amounts required to trigger higher degrees of the
crime of health care fraud are unacceptably high. New York must not
tolerate the loss of health care funding to fraud. Nor should we as a
State allow lenient treatment of individuals who view health care
fraud as a "business". According to the National Health Care
Anti-Fraud Association, health care fraud costs the United States
approximately $94 billion in 2004 alone. One estimate indicated that
health care fraud costs every man, woman and child in the United
States $11 per week or $550 per year. New York must make every effort
to reduce health care fraud. Reducing fraud will reduce health care
costs. Even one fraudulently submitted claim or one bill for services
never performed is too many. Under the current system of law, a
physician who charges $200 per visit for patients he/she never
actually sees could submit 14 fraudulent claims before triggering the
higher level crime contained in section 177.10.

Under this hypothetical example, the claims would not only cost money
but would cost insurance companies, Medicare, Medicaid etc" time and
resources investigating and processing these bogus claims, Other
crimes involving theft such as grand larceny are triggered at $1,000,
Theft of health care funds and services should not be treated
differently.

LEGISLATIVE HISTORY:
S.7275 of 2008
03/26/08 Referred to Codes
S.111 of 2009
01/07/09 REFERRED TO CODES
01/06/10 REFERRED TO CODES

FISCAL IMPLICATIONS:
None.


LOCAL FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
This act shall take effect immediately.

S1659-2011 Text

                      S T A T E   O F   N E W   Y O R K
  ________________________________________________________________________

                                    1659

                         2011-2012 Regular Sessions

                              I N  SENATE

                              January 11, 2011
                                 ___________

  Introduced  by  Sen. SAMPSON -- read twice and ordered printed, and when
    printed to be committed to the Committee on Codes

  AN ACT to amend the penal law, in relation to health care fraud

    THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
  BLY, DO ENACT AS FOLLOWS:


    Section 1. Section 177.10 of the penal law, as added by chapter 442 of
  the laws of 2006, is amended to read as follows:

  S 177.10 Health care fraud in the fourth degree.
    A person is guilty of health care fraud in the fourth degree when such
  person, on one or more occasions, commits the crime of health care fraud
  in the fifth degree and the payment or portion of the payment wrongfully
  received,  as the case may be, from a single health plan, in a period of
  not more than one year, exceeds [three]  ONE  thousand  dollars  in  the
  aggregate.
    Health care fraud in the fourth degree is a class E felony.
    S  2.  Section 177.15 of the penal law, as added by chapter 442 of the
  laws of 2006, is amended to read as follows:

  S 177.15 Health care fraud in the third degree.
    A person is guilty of health care fraud in the third degree when  such
  person, on one or more occasions, commits the crime of health care fraud
  in the fifth degree and the payment or portion of the payment wrongfully
  received,  as the case may be, from a single health plan, in a period of
  not more than one year, exceeds  [ten]  FIVE  thousand  dollars  in  the
  aggregate.
    Health care fraud in the third degree is a class D felony.
    S  3.  Section 177.20 of the penal law, as added by chapter 442 of the
  laws of 2006, is amended to read as follows:

  S 177.20 Health care fraud in the second degree.
    A person is guilty of health care fraud in the second degree when such
  person, on one or more occasions, commits the crime of health care fraud
  in the fifth degree and the payment or portion of the payment wrongfully

   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD05879-01-1

 S. 1659                             2

  received, as the case may be, from a single health plan, in a period  of
  not  more than one year, exceeds [fifty] TWENTY-FIVE thousand dollars in
  the aggregate.
    Health care fraud in the second degree is a class C felony.
    S  4.  Section 177.25 of the penal law, as added by chapter 442 of the
  laws of 2006, is amended to read as follows:

  S 177.25 Health care fraud in the first degree.
    A person is guilty of health care fraud in the first degree when  such
  person, on one or more occasions, commits the crime of health care fraud
  in the fifth degree and the payment or portion of the payment wrongfully
  received,  as the case may be, from a single health plan, in a period of
  not more than one year, exceeds  [one  million]  FIVE  HUNDRED  THOUSAND
  dollars in the aggregate.
    Health care fraud in the first degree is a class B felony.
    S 5. This act shall take effect immediately.