Prohibited acts - R.I. Gen. Laws Ann. § 27-8.2-3

Rhode Island prohibits individuals from perpetuating various acts of Medicaid fraud including:

• Presenting materially false or fraudulent claims for services, claims for medically unnecessary services.
• Presenting false and fraudulent claims for services.
• Presenting claims for unnecessary services.
• Submitting materially false or fraudulent information with the intent of obtaining greater compensation for services.
• Submitting materially false information in order to obtain authorization to provide services.
• Submitting claims, cost reports, or other documents that fail to fully disclose material information.
• Soliciting, receiving, offering, or paying remuneration as a means of obtaining referrals for services covered by the Rhode Island Medicaid program.

Rhode Island classifies Medicaid fraud as felony punishable by a maximum fine of $10,000 and/or 10 years imprisonment. Persons that refuse to submit information to the Medicaid fraud control unit, seek employment as or with a provider while excluded from participation in any federal health care program, or falsify information to obtain employment are guilty of a misdemeanor punishable by a fine of $5,000.