Free Consultation | Se habla español


when you need it most

Photo of Herbert J. Weston and Tanya L. Weston

What are the consequences for Medicaid fraud in California?

On Behalf of | Apr 25, 2019 | Firm News, White Collar Crimes

Medicaid is a growing concern in California, forcing the state to take aggressive measures to fight and put a stop to it. If you are guilty of committing Medicaid fraud in the Golden State, you may wonder what your future holds for you. Without a proper defense and adequate legal representation, you face jail time, hefty fines and a tarnished reputation.

You can find California’s Medicaid fraud laws at on the State of California Department of Justice website. If your crime involves making false declarations of eligibility—a crime that involves receiving or encouraging another to accept Medicaid benefits for which he or she is not truly eligible—the state may charge you with a misdemeanor or felony. Both may result in a term behind bars.

If you intentionally make a fraudulent claim to either obtain benefits or obtain more benefits than your condition warrants, the state may charge you with a misdemeanor or felony. A misdemeanor in this case carries a punishment of up to one year behind bars and a $1,000 fine. A felony, however, may result in a prison sentence of up to five years and a fine of up to three times the amount of improper disbursement or that claimed on the fraudulent claim.

If you received a kickback or bribe to promise or refer a person for service or merchandise, you may receive a misdemeanor or felony conviction. A misdemeanor conviction may result in up to one year in the county jail. A felony conviction, however, may mean you have to serve a term in state prison and pay a fine of up to $10,000.

If you knowingly make a fraudulent claim for health care benefits, you face up to one year in the local jail and a $1,000 fine or, if the charge is a more serious felony one, two to five years in the state penitentiary and up to $50,000 in fines, or twice the worth of the fraud, whichever is more. 

If you knowingly submit a claim for benefits of less than $950 that the claimant never ended up using, the state may charge you with a $1,000 fine and sentence you up to one year in county jail. However, if the claim exceeds $950, the state may charge you up to $50,000 in fines or twice the value of the fraud, whichever is greater. You may also have to serve up to five years in state prison.

The content of this article is intended for informational purposes only. You should not use it as legal advice.