Article 177 of the NY Penal Law: Health Care Fraud

Article 177 of the NY Penal Law explains what constitutes health care fraud in New York. According to the Law, healthcare fraud is divided into five different degrees. Although a crime of health care fraud is categorized as either a first, second-, third-, fourth- or fifth-degree crime depending on various factors, two elements are shared among all the degrees. Firstly, there is always a scheme to defraud a health care benefit program, and secondly, defendants willingly and knowingly execute their crimes.

Health Care Fraud in the Fifth Degree

This crime involves the intentional, and willful defrauding of a health plan. A fifth-degree crime has no total dollar or time limitation.

In New York, such a crime is a Class A misdemeanor.

A crime in the fifth degree is punishable by up to one year in jail.

Health Care Fraud in the Fourth Degree

You are guilty of health care fraud in the fourth degree when you commit a crime in the fifth degree once or more than once and illegally receive more than $3,000 in one year.

It is a class E non-violent felony.

A health care fraud crime in the fourth degree is punishable by a prison sentence of up to four years.

Health Care Fraud in the Third Degree

You are guilty of health care fraud in the third degree when you commit a crime in the fifth degree once or more than once and illegally obtain over $10,000 in no more than one year.

A crime in the third degree is a class D non-violent felony.

If found guilty of health care fraud in the third degree, you risk spending up to seven years in prison.

Health Care Fraud in the Second Degree

A second-degree crime involves committing a crime in the fifth degree and obtaining more than $50,000 in not more than one year.

This Class C non-violent felony is punishable by up to fifteen years in prison.

Health Care Fraud in the First Degree

To be convicted of health care fraud in the first degree, a person must be found guilty of committing a crime in the fifth degree and illegally receiving more than $1 million in not more than a year.

Health care fraud in the first degree is a class B non-violent felony, and carries a minimum jail sentence of one to three years. The maximum jail sentence can go up to 25 years, depending on the specifics of the case.

Common Defenses To Health Care Fraud in New York

If you stand accused of health care fraud, you must understand the defenses you can use to help your case.

For example, suppose you are an employee such as a clerk, who is not actively involved with managing and controlling the affairs of the company you work for. In that case, you and your attorney can come up with a strong defense if you simply executed your employer’s or superior employee’s orders, without personal benefit.

Contact an Experienced NYC Health Care Fraud Lawyer Today

If you are in New York and need help with a health care fraud charge, contact experienced NYC health care fraud attorney Mark I. Cohen to maximize your chances of preserving your freedom and maintaining your assets.

Resource:

nysenate.gov/legislation/laws/PEN/P3TKA177