36-2991. Fraud; penalties; enforcement;
violation; classification
A. A person shall not provide or cause to be provided false or fraudulent
information on an application for eligibility pursuant to this article.
B. A person who violates subsection A of this section, who is determined eligible
for services pursuant to this article and who would have been determined ineligible if
the person had provided true and correct information is subject, in addition to any other
penalties that may be prescribed by federal or state law, to a civil penalty of not more
than the amount incurred by the system, including capitation payments made on behalf of
the person. In addition, the person's eligibility may be discontinued in accordance with
rules adopted by the director.
C. In addition to the requirements of state law, any applicable fraud and abuse
controls that are enacted under federal law apply to persons who are eligible for
services under this article and to contractors and noncontracting providers who provide
services under this article.
D. The director shall make the determination to assess a civil penalty and is
responsible for collection of the penalty. The director may adopt rules that prescribe
procedures for the determination and collection of civil penalties. The director may
compromise civil penalties imposed under this section in accordance with criteria
established in rules.
E. The director shall adopt rules providing for the appeal of a decision by a
person adversely affected by a determination made by the director under this
section. The director's final decision is subject to judicial review pursuant to title
12, chapter 7, article 6.
F. Amounts paid by the state and recovered under this section shall be deposited in
the state general fund, and any applicable federal share shall be returned to the United
States department of health and human services.
G. If a civil penalty imposed pursuant to subsection D of this section is not paid,
the state may file an action to collect the civil penalty in the superior court in
Maricopa county. Matters that were raised or could have been raised in a hearing before
the director or in an appeal pursuant to title 12, chapter 7, article 6 may not be raised
as a defense to the civil action. An action brought pursuant to this subsection shall be
initiated within six years after the date the claim is presented.
H. A person who knowingly aids or abets another person pursuant to section 13-301,
13-302 or 13-303 in the commission of an offense under this section or section 13-3713 is
guilty of a class 5 felony.
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