Ohio Rev. Code » Chapter 2913 - Ohio Revised Code | Ohio Laws
Ohio Revised Code

Ohio Rev. Code § 2913.40 (2026)

Medicaid fraud

✓ current as of May 2026
Find cases: SyfertCases citing this section ORCcodes.ohio.gov (official) Justiaon Justia CornellLII Search CasesGoogle Scholar
Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
PDF:
Download Authenticated PDF
 

(A) As used in this section:

(1) "Statement or representation" means any oral, written, electronic, electronic impulse, or magnetic communication that is used to identify an item of goods or a service for which reimbursement may be made under the medicaid program or that states income and expense and is or may be used to determine a rate of reimbursement under the medicaid program.

(2) "Provider" means any person who has signed a provider agreement with the department of medicaid to provide goods or services pursuant to the medicaid program or any person who has signed an agreement with a party to such a provider agreement under which the person agrees to provide goods or services that are reimbursable under the medicaid program.

(3) "Provider agreement" has the same meaning as in section 5164.01 of the Revised Code.

(4) "Recipient" means any individual who receives goods or services from a provider under the medicaid program.

(5) "Records" means any medical, professional, financial, or business records relating to the treatment or care of any recipient, to goods or services provided to any recipient, or to rates paid for goods or services provided to any recipient and any records that are required by the rules of the medicaid director to be kept for the medicaid program.

(B) No person shall knowingly make or cause to be made a false or misleading statement or representation for use in obtaining reimbursement from the medicaid program.

(C) No person, with purpose to commit fraud or knowing that the person is facilitating a fraud, shall do either of the following:

(1) Contrary to the terms of the person's provider agreement, charge, solicit, accept, or receive for goods or services that the person provides under the medicaid program any property, money, or other consideration in addition to the amount of reimbursement under the medicaid program and the person's provider agreement for the goods or services and any cost-sharing expenses authorized by section 5162.20 of the Revised Code or rules adopted by the medicaid director regarding the medicaid program.

(2) Solicit, offer, or receive any remuneration, other than any cost-sharing expenses authorized by section 5162.20 of the Revised Code or rules adopted by the medicaid director regarding the medicaid program, in cash or in kind, including, but not limited to, a kickback or rebate, in connection with the furnishing of goods or services for which whole or partial reimbursement is or may be made under the medicaid program.

(D) No person, having submitted a claim for or provided goods or services under the medicaid program, shall do either of the following for a period of at least six years after a reimbursement pursuant to that claim, or a reimbursement for those goods or services, is received under the medicaid program:

(1) Knowingly alter, falsify, destroy, conceal, or remove any records that are necessary to fully disclose the nature of all goods or services for which the claim was submitted, or for which reimbursement was received, by the person;

(2) Knowingly alter, falsify, destroy, conceal, or remove any records that are necessary to disclose fully all income and expenditures upon which rates of reimbursements were based for the person.

(E) Whoever violates this section is guilty of medicaid fraud. Except as otherwise provided in this division, medicaid fraud is a misdemeanor of the first degree. If the value of property, services, or funds obtained in violation of this section is one thousand dollars or more and is less than seven thousand five hundred dollars, medicaid fraud is a felony of the fifth degree. If the value of property, services, or funds obtained in violation of this section is seven thousand five hundred dollars or more and is less than one hundred fifty thousand dollars, medicaid fraud is a felony of the fourth degree. If the value of the property, services, or funds obtained in violation of this section is one hundred fifty thousand dollars or more, medicaid fraud is a felony of the third degree.

(F) Upon application of the governmental agency, office, or other entity that conducted the investigation and prosecution in a case under this section, the court shall order any person who is convicted of a violation of this section for receiving any reimbursement for furnishing goods or services under the medicaid program to which the person is not entitled to pay to the applicant its cost of investigating and prosecuting the case. The costs of investigation and prosecution that a defendant is ordered to pay pursuant to this division shall be in addition to any other penalties for the receipt of that reimbursement that are provided in this section, section 5164.35 of the Revised Code, or any other provision of law.

(G) The provisions of this section are not intended to be exclusive remedies and do not preclude the use of any other criminal or civil remedy for any act that is in violation of this section.
Notes of Decisions
Cited in 26 cases (6 in the last 5 years), 1990–2025 · leading case: State v. Dolce, 637 N.E.2d 51 (Ohio Ct. App. 1993).
Sort: Relevance Newest Treatment
State v. Dolce, 637 N.E.2d 51 (Ohio Ct. App. 1993). · cites it 9× “47 and guilty of Medicaid fraud in violation of R.C. 2913.40. Dolce was sentenced and ordered to pay the costs of the investigation and prosecution.”
State v. Vogelsong, 612 N.E.2d 462 (Ohio Ct. App. 1992). · cites it 6× “Defendants appeal from their conviction of Medicaid fraud in violation of R.C. 2913.40(B). Case No. 91AP-1282 involves defendant James D.”
State v. Cottingham, 2020 Ohio 4220 (Ohio Ct. App. 2020). “02(A)(3); Count 19, Medicaid fraud in violation of R.C. 2913.40(B); Count 20, forgery in violation of R.”
State v. Brown, 651 N.E.2d 470 (Ohio Ct. App. 1994). · cites it 2× “Counts one, two, four, five and six of the indictment alleged Medicaid fraud, a violation of R.C. 2913.40. Counts three and seven alleged theft by deception, a violation of R.”
State v. Harris, 2018 Ohio 3872 (Ohio Ct. App. 2018). · cites it 2× “02(A)(3), a felony of the fourth degree; and Medicaid fraud, in violation of R.C. 2913.40(D), a felony of the fourth degree.”
DeBlanco v. Ohio State Med. Bd., 604 N.E.2d 212 (Ohio Ct. App. 1992). · cites it 2× “The charge was that: “On or about September 18, 1989, you were found guilty in the Common Pleas Court of Franklin County of one (1) count of Medicaid fraud, a felony of *200 the third degree, in violation of Section 2913.40(B), Ohio Revised Code; one (1) count of grand theft, a…”
State v. Kpoto, 2020 Ohio 3866 (Ohio Ct. App. 2020). · cites it 2× “" R.C. 2913.40(B). A person acts knowingly, regardless of purpose, when the person is aware that the person's conduct will probably cause a certain result or will probably be of a certain nature.”
State v. Perz, 877 N.E.2d 702 (Ohio Ct. App. 2007). “71(D) states that in arson cases, the trial court “shall order the offender, as part of the offender’s sentence, to reimburse the [investigating] agencies from the offender’s assets for all or a specified portion of *106 their established costs”; and R.C. 2913.40(F) allows the…”
State v. Anderson, 2018 Ohio 4618 (Ohio Ct. App. 2018). “FACTS AND PROCEDURAL HISTORY {¶ 2} On May 17, 2016, a Franklin County Grand Jury indicted appellant on one count of Medicaid fraud, a fourth-degree felony, in violation of R.C. 2913.40(B), and one count of theft, a fourth-degree felony, in violation of R.”
State v. Balo, 2011 Ohio 3341 (Ohio Ct. App. 2011). “02(A)(3)), Medicaid fraud (R.C. 2913.40), passing bad checks (R.C. 2913.”
State v. S.R., 2021 Ohio 4458 (Ohio Ct. App. 2021). · cites it 2× “02(A)(3), felonies of the fifth degree (Counts 1 and 2); and one count of medicaid fraud in violation of R.C. 2913.40(B), a misdemeanor of the first degree (Count 3).”
State v. Clark, 2021 Ohio 559 (Ohio Ct. App. 2021). · cites it 3× “02(A)(3), a felony of the fourth degree, and one count of Medicaid fraud in violation of R.C. 2913.40(B), a felony of the fourth degree.”
Show all 26 citing cases →
— Ohio Rev. Code § 2913.40(B) — 17 cases
State v. Vogelsong, 612 N.E.2d 462 (Ohio Ct. App. 1992). “Defendants appeal from their conviction of Medicaid fraud in violation of R.C. 2913.40(B). Case No. 91AP-1282 involves defendant James D.”
State v. Cottingham, 2020 Ohio 4220 (Ohio Ct. App. 2020). “02(A)(3); Count 19, Medicaid fraud in violation of R.C. 2913.40(B); Count 20, forgery in violation of R.”
DeBlanco v. Ohio State Med. Bd., 604 N.E.2d 212 (Ohio Ct. App. 1992). “The charge was that: “On or about September 18, 1989, you were found guilty in the Common Pleas Court of Franklin County of one (1) count of Medicaid fraud, a felony of *200 the third degree, in violation of Section 2913.40(B), Ohio Revised Code; one (1) count of grand theft, a…”
State v. Kpoto, 2020 Ohio 3866 (Ohio Ct. App. 2020). “" R.C. 2913.40(B). A person acts knowingly, regardless of purpose, when the person is aware that the person's conduct will probably cause a certain result or will probably be of a certain nature.”
State v. Anderson, 2018 Ohio 4618 (Ohio Ct. App. 2018). “FACTS AND PROCEDURAL HISTORY {¶ 2} On May 17, 2016, a Franklin County Grand Jury indicted appellant on one count of Medicaid fraud, a fourth-degree felony, in violation of R.C. 2913.40(B), and one count of theft, a fourth-degree felony, in violation of R.”
— Ohio Rev. Code § 2913.40(D) — 2 cases
State v. Harris, 2018 Ohio 3872 (Ohio Ct. App. 2018). “02(A)(3), a felony of the fourth degree; and Medicaid fraud, in violation of R.C. 2913.40(D), a felony of the fourth degree.”
Frank v. The Good Samaritan Hosp. of Cincinnati, Ohio (S.D. Ohio 2020).
— Ohio Rev. Code § 2913.40(E) — 2 cases
State v. Wiley, 2017 Ohio 2744 (Ohio Ct. App. 2017).
State v. Stewart, 2023 Ohio 1493 (Ohio Ct. App. 2023).
— Ohio Rev. Code § 2913.40(F) — 2 cases
State v. Dolce, 637 N.E.2d 51 (Ohio Ct. App. 1993). “47 and guilty of Medicaid fraud in violation of R.C. 2913.40. Dolce was sentenced and ordered to pay the costs of the investigation and prosecution.”
State v. Perz, 877 N.E.2d 702 (Ohio Ct. App. 2007). “71(D) states that in arson cases, the trial court “shall order the offender, as part of the offender’s sentence, to reimburse the [investigating] agencies from the offender’s assets for all or a specified portion of *106 their established costs”; and R.C. 2913.40(F) allows the…”
Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.