Health care fraud in the fifth degree · as in force on May 31, 2026
§ 177.05 Health care fraud in the fifth degree.
A person is guilty of health care fraud in the fifth degree when, with intent to defraud a health plan, he or she knowingly and willfully provides materially false information or omits material information for the purpose of requesting payment from a health plan for a health care item or service and, as a result of such information or omission, he or she or another person receives payment in an amount that he, she or such other person is not entitled to under the circumstances.
Health care fraud in the fifth degree is a class A misdemeanor.
A person commits fifth-degree health care fraud by knowingly and willfully giving materially false information or omitting material information, intending to defraud a health plan and request payment for a health-care item or service, when that conduct causes anyone to receive payment they are not entitled to. ★ It is a class A misdemeanor.
Marked in the text: penalties, time limits, sums of money. Editorial emphasis added by this edition; it does not appear in the statute as enacted.
This provision appears in Volume 4 — The Court Clerk: Penal Law; Volume 1 — The Court Officer in Plain English; Volume 3 — The Court Officer: Penal Law; Volume 3 — Your Career: Penal Law in Plain English.