The bill H. 5285 aims to amend the South Carolina Code of Laws regarding Medicaid fraud by introducing tiered criminal penalties based on the amount of fraud committed. It modifies Sections 43-7-60 and 43-7-70 to establish specific penalties for false claims related to Medicaid, categorizing offenses into misdemeanors and felonies depending on the economic advantage sought or received. For instance, individuals committing fraud for amounts less than $5,000 face misdemeanor charges, while those involved in fraud exceeding $50,000 may face felony charges with significant fines and imprisonment. Additionally, the bill mandates that convicted individuals must make full restitution to victims of their fraud.

Furthermore, the bill enhances the authority of the Attorney General by allowing the issuance of administrative subpoenas for fraud investigations and the ability to initiate legal proceedings. It also includes provisions for civil penalties and the possibility of consent agreements between the Attorney General and alleged violators, which would not be admissible in subsequent legal proceedings. The proposed changes are designed to strengthen the enforcement of Medicaid fraud laws and ensure accountability among providers and recipients within the state's Medicaid program.

Statutes affected:
02/26/2026: 43-7-60, 43-7-90
Latest Version: 43-7-60, 43-7-90