Alabama Public Assistance Fraud

Code of Alabama, Title 13A Criminal Code, Chapter 9, Article 7

• Ala. Code § 13A-9-150 - Public Assistance Fraud

Public assistance means money or property that the government (federal, state, political subdivisions, public housing authorities, etc.) provides directly or indirectly to eligible people. (§ 13A-9-150(a)). Examples of public assistance include:

• Food stamps
• EBT cards
• Supplemental Nutrition Assistance Program (SNAP)
• The Family Assistance Program
• The JOBS Program

A food assistance authorization’s value is the cash or exchange value that the person or business obtains through the fraudulent act. (§ 13A-9-150(f))

Public assistance fraud includes the following actions (among others):

• Entering fraudulent records in a computer system
• Unauthorized use of computer facilities
• Intentionally or deliberately altering or destroying computer information or files
• Fraudulent billing or charging
• Stealing financial instruments, data, or other assets (§ 13A-9-150(g))

A person or business entity that knowingly does any of the following commits public assistance fraud:

• Fails to disclose a material fact used to determine whether they qualify for public assistance through the use of a false statement, misrepresentation, impersonation, or other fraudulent means. (§ 13A-9-150(b)(1))
• Fails to disclose a change in circumstances so they can continue to receive public assistance when, if they reported the change, they would no longer qualify for public assistance or receive less public assistance. (§ 13A-9-150(b)(2))
• They aid or abet another person to commit violations of either § 13A-9-150(b)(1) or § 13A-9-150(b)(2). (§ 13A-9-150(b)(3))
• Use, transfer, acquire, traffic, alter, forge, possess, attempt those things, or attempt to aid and abet another person in the use, transfer, acquisition, traffic, alteration, forgery, or possession of a food assistance identification card, an authorization for food assistance benefits, a certificate of eligibility for medical services, a Medicaid identification card, or to re-encode a magnetic strip on a card with information the state or a federal agency issued that grants monetary benefits that the agency did not issue, or does not match the information on the front of the card. (§ 13A-9-150(b)(4))
• File, attempt to file, or aid and abet the filing of a claim for services to, or on behalf of, a recipient of public assistance for services that were not rendered. (§ 13A-9-150(b)(5))
• File a false claim or a claim for unauthorized items or services from public assistance programs that the state or federal government funds. (§ 13A-9-150(b)(6))
• Bill a person (or their family) who receives public assistance an amount in excess of what law or regulations provide for. (§ 13A-9-150(b)(7))
• Fail to credit, return, or pay back payments received from Social Security, insurance, or other state agency-provided funds that exceed the approved or listed amounts or that the person received based on fraud or fraudulent conduct. (§ 13A-9-150(b)(8))
• Receive, attempt to receive, or aid and abet the receipt of unauthorized payments or public assistance, including the receipt of unauthorized public assistance, authorization, or identification to obtain public assistance. (§ 13A-9-150(b)(9))
• Taking, converting, charging, or accepting public assistance program funds in excess of the listed price plus applicable taxes. (§ 13A-9-150(b)(10))
• Receiving payment that includes public assistance funds of any kind or form for the purchase of items that state or federal law prohibits or does not authorize. (§ 13A-9-150(b)(11))

A hospital violates § 13A-9-150(b) if any of its employees, agents, contractors, subcontractors, independent contractors, physicians, or a physician’s employee or agent make a claim or obtain payment for a health care item or service with the actual knowledge that they are not entitled to the claim or payment, or with the actual knowledge that the patient is not entitled to coverage under a public assistance program. (§ 13A-9-150(c))

Any person who has duties in the administration of a public assistance program, in the distribution of public assistance, or with authorization or identification to obtain public assistance who does any of the following has also committed public assistance fraud:

• They fraudulently misappropriate, attempt to misappropriate, knowingly fail to disclose fraudulent activity, or aid and abet in the misappropriation of a food assistance card or identification card, authorization for food assistance, a certificate of eligibility for prescribed medicine, a Medicaid identification card, or any other public assistance program in which they are entrusted, or they have gained possession of due to their position. (§ 13A-9-150(d)(1))
• They knowingly misappropriate, attempt to misappropriate, or aid and abet the misappropriation of funds given in exchange for food assistance program benefits or any authorization for food assistance benefits. (§ 13A-9-150(d)(2))

The following penalties apply in addition to any other lawful penalty:

• If the aggregate value of the violation exceeds $200, the person or business is guilty of a Class C felony. (§ 13A-9-150(e)(1))
• If the aggregate value is less than $200, the person or business is guilty of a Class A misdemeanor. (§ 13A-9-150(e)(2))
• A person of business that commits three or more violations of this section establishes a rebuttable presumption that they knowingly violated it. (§ 13A-9-150(e)(3))