MO SB952

Repeals and rewrites section 191.905, RSMo, to establish comprehensive fraud provisions for MO HealthNet health care payments.

Prohibits health care providers from knowingly making false statements about medical necessity, concealing events affecting eligibility, failing to disclose information to obtain improper payments, or misrepresenting the value of health care provided.

Criminalizes solicitation or receipt of kickbacks, bribes, or rebates in connection with health care referrals or purchases, with penalties of class C felony on first conviction and class B felony on subsequent convictions.

Establishes two new state treasury funds: the MO HealthNet Fraud Reimbursement Fund (for restitution to federal and state governments) and the MO HealthNet Fraud Prosecution Revolving Fund (for investigation and prosecution costs).

Imposes civil penalties of $5,000 to $10,000 per violation plus up to triple damages for violations, with reduced damages of up to double if defendant self-reports within 30 days and fully cooperates with investigation.