South Carolina H 5285: Second Chance Month

Bill Text

2025-2026 Bill 5285 Text of Previous Version (Feb. 26, 2026) - South Carolina Legislature Online 

South Carolina General Assembly
126th Session, 2025-2026

Bill 5285

Indicates Matter Stricken
Indicates New Matter

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A bill

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY AMENDING 
SECTIONS 43-7-60 AND 43-7-70, RELATING TO PROVIDER AND RECIPIENT MEDICAID 
FRAUD, SO AS TO CREATE TIERED CRIMINAL PENALTIES CORRELATING TO THE AMOUNT OF 
FRAUD, TO REQUIRE RESTITUTION, TO AUTHORIZE THE ATTORNEY GENERAL'S USE OF 
CONSENT AGREEMENTS, AND FOR OTHER PURPOSES; AND BY AMENDING SECTION 43-7-90, 
RELATING TO ENFORCEMENT OF SECTIONS 43-7-60 TO 43-7-80, SO AS TO AUTHORIZE THE 
ATTORNEY GENERAL TO ISSUE ADMINISTRATIVE SUBPOENAS AND INSTITUTE PROCEEDINGS.

Be it enacted by the 
General Assembly of the State of South Carolina:

SECTION 1. Section 43-7-60 of the S.C. Code is amended to read:

 Section 
43-7-60. (A) For purposes of this 
section:

 (1) 
"provider" includes "Provider" 
means a person who provides goods, services, or assistance and who is 
entitled or claims to be entitled to receive reimbursement, payment, or 
benefits under the state's Medicaid program. "Provider" also 
includes an owner, a billing agent, and a 
person acting as an employee, representative, or agent of the provider.

 (2) 
"false False claim, 
statement, or representation" means a claim, statement, or representation made 
or presented, or attempted to be made or presented, 
in any form including, but not limited to, a claim, statement, or 
representation which is computer generated or transmitted or made, produced, or 
transmitted by an electronic means or device.

 (3) "State Medicaid program" means the 
state or federal agency which administers or assists in the administration of 
the state Medicaid program and a managed care organization or similar entity under 
contract with the state Medicaid program to provide goods, services, or 
assistance.

 (B) It 
is unlawful for a provider of medical assistance, goods, or services to 
knowingly and wilfully make or cause to be made a false claim, statement, or 
representation of a material fact:

 (1) 
in an application or request, including an electronic or computer generated 
claim, for a benefit, payment, or reimbursement from a 
state or federal agency which administers or assists in the administration of 
the state's medical assistance or the state Medicaid 
program; or

 (2) 
on a report, certificate, or similar document, including an electronic or 
computer generated claim, submitted to a state or federal 
agency which administers or assists in the administration of the state'sthe state Medicaid program in order for a provider or 
facility to qualify or remain qualified under the state'sstate Medicaid program to provide assistance, goods, or 
services, or receive reimbursement, payment, or benefit for this assistance, 
goods, or services.

 For purposes of this 
subsection, each false claim, representation, or statement constitutes a 
separate offense.

 (C) It 
is unlawful for a provider of medical assistance, goods, or services knowingly 
and wilfully to conceal or fail to disclose any material fact, event, or 
transaction which affects the:

 (1) 
provider's initial or continued entitlement to payment, reimbursement, or 
benefits under the state'sstate 
Medicaid planprogram; 
or

 (2) 
amount of payment, reimbursement, or benefit to which the provider may be 
entitled for services, goods, or assistance rendered.

 For purposes of this 
subsection, each fact, event, or transaction concealed or not disclosed 
constitutes a separate offense.

 (D) A person who violates the 
provisions of this section is guilty of medical assistance provider fraud, a 
Class A misdemeanor and, upon conviction, must be imprisoned not more than 
three years and fined not more than one thousand dollars for each offense.

 (D)(1) 
A person who, in violation of the provisions of this section, knowingly makes a 
false claim, statement, or misrepresentation, or who knowingly assists, abets, 
solicits, or conspires with a person to make a false claim, statement, or 
misrepresentation is guilty of a misdemeanor if the amount of economic 
advantage or benefit sought or received is less than five thousand dollars and, 
upon conviction, must be fined not more than one thousand dollars or imprisoned 
not more than three years, or both.

 (2) A person who, in violation of the 
provisions of this section, knowingly makes a false claim, statement, or 
misrepresentation, or who knowingly assists, abets, solicits, or conspires with 
a person to make a false claim, statement, or misrepresentation is guilty of a felony 
if the amount of economic advantage or benefit sought or received is at least five 
thousand dollars but less than fifty thousand dollars and, upon conviction, 
must be fined not less than five thousand dollars nor more t