Form Cms-855i - Medicare Enrollment Application - Physicians And Non-Physician Practitioners Page 24

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SECtion 14: PEnaltiES for f alSifying inforMa tion
this section explains the penalties for deliberately furnishing false information in this application
to gain or maintain enrollment in the Medicare program.
1. 1.18 U.S.C. § 1001 authorizes criminal penalties against an individual who, in any matter within
the jurisdiction of any department or agency of the United States, knowingly and willfully falsifies,
conceals or covers up by any trick, scheme or device a material fact, or makes any false, fictitious, or
fraudulent statements or representations, or makes any false writing or document knowing the same to
contain any false, fictitious or fraudulent statement or entry. Individual offenders are subject to fines
of up to $250,000 and imprisonment for up to five years. Offenders that are organizations are subject
to fines of up to $500,000 (18 U.S.C. § 3571). Section 3571(d) also authorizes fines of up to twice
the gross gain derived by the offender if it is greater than the amount specifically authorized by the
sentencing statute.
2. Section 1128B(a)(1) of the Social Security Act authorizes criminal penalties against any individual
who, “knowingly and willfully,” makes or causes to be made any false statement or representation of
a material fact in any application for any benefit or payment under a Federal health care program. The
offender is subject to fines of up to $25,000 and/or imprisonment for up to five years.
3. The Civil False Claims Act, 31 U.S.C. § 3729, imposes civil liability, in part, on any person who:
a) knowingly presents, or causes to be presented, to an officer or any employee of the United
States Government a false or fraudulent claim for payment or approval;
b) knowingly makes, uses, or causes to be made or used, a false record or statement to get a false or
fraudulent claim paid or approved by the Government; or
c) conspires to defraud the Government by getting a false or fraudulent claim allowed or paid.
The Act imposes a civil penalty of $5,000 to $10,000 per violation, plus three times the amount of
damages sustained by the Government
4. Section 1128A(a)(1) of the Social Security Act imposes civil liability, in part, on any person (including
an organization, agency or other entity) that knowingly presents or causes to be presented to an officer,
employee, or agent of the United States, or of any department or agency thereof, or of any State
agency…a claim…that the Secretary determines is for a medical or other item or service that the
person knows or should know:
a) was not provided as claimed; and/or
b) the claim is false or fraudulent.
This provision authorizes a civil monetary penalty of up to $10,000 for each item or service, an
assessment of up to three times the amount claimed, and exclusion from participation in the Medicare
program and State health care programs.
5. 18 U.S.C. 1035 authorizes criminal penalties against individuals in any matter involving a health
care benefit program who knowingly and willfully falsifies, conceals or covers up by any trick,
scheme, or device a material fact; or makes any materially false, fictitious, or fraudulent statements
or representations, or makes or uses any materially false fictitious, or fraudulent statement or entry, in
connection with the delivery of or payment for health care benefits, items or services. The individual
shall be fined or imprisoned up to 5 years or both.
CMS-855I (07/11)
23

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