Fraud. any intentional deception made for personal gain or to damage another individual, group, or entity. It includes any act that constitutes fraud under applicable federal or state law. Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347).
Appears in 23 contracts
Samples: www.dhs.wisconsin.gov, Family Care Agreement, www.dhs.wisconsin.gov
Fraud. any The intentional deception or misrepresentation made for personal gain by a person with the knowledge that the deception could result in some unauthorized benefit to himself or to damage another individual, group, or entitysome other person. It includes any act that constitutes fraud under applicable federal Federal or state State law. Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347).
Appears in 12 contracts
Samples: medicaid.ms.gov, medicaid.ms.gov, medicaid.ms.gov
Fraud. any An intentional deception or misrepresentation made for personal gain by a person or entity with the knowledge that the deception could result in some unauthorized benefit to damage another individualhim/herself, group, itself or some other person or entity. It includes any act that constitutes fraud under applicable federal or state law. Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347).
Appears in 10 contracts
Samples: www.forwardhealth.wi.gov, www.forwardhealth.wi.gov, www.forwardhealth.wi.gov
Fraud. any An intentional deception or misrepresentation made for personal by a person with the knowledge that the deception could result in some unauthorized benefit or financial gain to him/herself or to damage another individual, group, or entitysome other person. It includes any act that constitutes fraud Fraud under applicable federal or state State law. Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347).
Appears in 7 contracts
Samples: Attachment E Business Associate Agreement, Business Associate Agreement (Wellcare Health Plans, Inc.), Business Associate Agreement (Wellcare Health Plans, Inc.)
Fraud. any An intentional deception or misrepresentation made for personal gain by a person with the knowledge that the deception results in unauthorized benefit to that person or to damage another individual, group, or entityperson. It The term includes any act that constitutes fraud under applicable federal or state law. Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347).
Appears in 6 contracts
Samples: www.dhhs.nh.gov, Standard Contract (Wellcare Health Plans, Inc.), Standard Contract (Wellcare Health Plans, Inc.)
Fraud. any An intentional deception or misrepresentation made for personal gain by a person with the knowledge that the deception results in unauthorized benefit to herself or to damage himself or another individual, group, or entityperson. It The term includes any act that constitutes fraud under applicable federal or state law. Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347).
Appears in 4 contracts
Samples: Contract (Wellcare Health Plans, Inc.), Wellcare Health Plans, Inc., ahca.myflorida.com
Fraud. any An intentional deception or misrepresentation made for personal gain by a person with the knowledge that the deception could result in some unauthorized benefit to him/herself or to damage another individual, group, or entitysome other person. It includes any act that constitutes fraud under applicable federal or state law. Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain law (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347see 42 CFR 455.2).
Appears in 4 contracts
Samples: www.uhchearing.com, www.uhchearing.com, www-prd.uhcprovider.com
Fraud. any Any intentional deception or misrepresentation made for personal gain by an individual or entity with the knowledge that the deception could result in some unauthorized benefit to damage another the individual, groupthe entity, or entitysome other person. It This includes any act that constitutes fraud Fraud under applicable federal or state State law. Beneficiary Fraud is knowingly and willfully executing, means the altering of information or attempting documents in order to execute, a scheme or artifice to defraud any health care benefit program fraudulently receive unauthorized benefits or to knowingly permit others to use the Beneficiary’s identification card to obtain (by means of false services or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347)supplies.
Appears in 2 contracts
Samples: dam.assets.ohio.gov, www.cms.gov
Fraud. any Any type of intentional deception made for personal gain or to damage another individualmisrepresentation, group, or entity. It includes including any act that constitutes fraud under applicable federal Federal or state law. Fraud is knowingly and willfully executingState Law, made by an entity or person with the knowledge that the deception could result in some unauthorized benefit to the entity or person, or attempting to execute, some other person in a scheme or artifice to defraud any health managed care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347)setting.
Appears in 2 contracts
Samples: www.dhs.pa.gov, www.magellanofpa.com
Fraud. any An intentional deception made for personal gain or misrepresentation by a person or an entity with the knowledge that the deception could result in some unauthorized benefit to damage another individual, group, himself or entitysome other person. It includes any act that constitutes fraud under applicable federal or state law, consistent with NMAC 8.305.13.10. Fraud is knowingly and willfully executing[See, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program (18 U.S.C. 1347)NMAC 8.305.1.7.]
Appears in 1 contract
Samples: Health Services Contract