Ohio Rev. Code » Chapter 2913
Ohio Revised Code

Ohio Rev. Code § 2913.401 (2026)

Medicaid eligibility fraud

✓ current as of May 2026
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Effective:
September 30, 2025
Latest Legislation:
House Bill 96 - 136th General Assembly
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(A) As used in this section:

(1) "Medicaid services" has the same meaning as in section 5164.01 of the Revised Code.

(2) "Property" means any real or personal property or other asset in which a person has any legal title or interest.

(B) No person shall knowingly do any of the following in an application for enrollment in the medicaid program or in a document that requires a disclosure of assets for the purpose of determining eligibility for the medicaid program:

(1) Make or cause to be made a false or misleading statement;

(2) Conceal an interest in property;

(3)(a) Except as provided in division (B)(3)(b) of this section, fail to disclose a transfer of property that occurred during the period beginning thirty-six months before submission of the application or document and ending on the date the application or document was submitted;

(b) Fail to disclose a transfer of property that occurred during the period beginning sixty months before submission of the application or document and ending on the date the application or document was submitted and that was made to an irrevocable trust a portion of which is not distributable to the applicant for or recipient of medicaid or to a revocable trust.

(C)(1) Whoever violates this section is guilty of medicaid eligibility fraud. Except as otherwise provided in this division, a violation of this section is a misdemeanor of the first degree. If the value of the medicaid services paid as a result of the violation is one thousand dollars or more and is less than seven thousand five hundred dollars, a violation of this section is a felony of the fifth degree. If the value of the medicaid services paid as a result of the violation is seven thousand five hundred dollars or more and is less than one hundred fifty thousand dollars, a violation of this section is a felony of the fourth degree. If the value of the medicaid services paid as a result of the violation is one hundred fifty thousand dollars or more, a violation of this section is a felony of the third degree.

(2) In addition to imposing a sentence under division (C)(1) of this section, the court may order that a person who is guilty of medicaid eligibility fraud make restitution in the amount of two hundred per cent of any medicaid services paid on behalf of an applicant for or recipient of medicaid for which the applicant or recipient was not eligible, plus interest at the rate applicable to judgments on unreimbursed amounts from the date on which the medicaid services were paid to the date on which restitution is made.

(3) The remedies and penalties provided in this section are not exclusive and do not preclude the use of any other criminal or civil remedy for any act that is in violation of this section.

(D) This section does not apply to a person who fully disclosed in an application for medicaid or in a document that requires a disclosure of assets for the purpose of determining eligibility for medicaid all of the interests in property of the applicant for or recipient of medicaid, all transfers of property by the applicant for or recipient of medicaid, and the circumstances of all those transfers.

(E) Any amounts of medicaid services recovered as restitution under this section and any interest on those amounts shall be credited to the general revenue fund, and any applicable federal share shall be returned to the appropriate agency or department of the United States.

Last updated July 21, 2025 at 10:46 AM

Notes of Decisions
Cited in 5 cases, 2011–2020 · leading case: Jacobson v. Kaforey (Slip Opinion), 2016-Ohio-8434, 75 N.E.3d 203.
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Jacobson v. Kaforey (Slip Opinion), 2016-Ohio-8434, 75 N.E.3d 203. · cites it 8× “65(A) (“The attorney general may bring a civil action * * * on behalf of the department of medicaid, and the prosecuting attorney of the county in which a violation of division (B) of section 2913.401 [Medicaid eligibility fraud] of the Revised Code occurs may bring a civil…”
State v. Rivarde, 966 N.E.2d 301 (Ohio Ct. App. 2011). · cites it 6× “” {¶ 5} In her single assignment of error, appellant initially argues that her conviction was improper because she could not be charged and convicted “under a general statute, like tampering with records, where a specific statute applies,” namely, falsification in violation of R.”
Smith v. Smith, 2019-Ohio-129, 128 N.E.3d 914. “See R.C. 2913.401(B)(1) ("No person shall knowingly[,] * * * in an application for enrollment in the medicaid program or in a document that requires a disclosure of assets for the purpose of determining eligibility for the medicaid program[,] [m]ake or cause to be made a false…”
State v. Brown, 2020-Ohio-5314. “42, a third-degree felony; and five counts of Medicaid eligibility fraud in violation of R.C. 2913.401, fourth-degree felonies. As part of a plea agreement, the state amended the indictment and consolidated some charges.”
State v. Mahvi, 2018-Ohio-4944. · cites it 2× “{¶36} Medicaid eligibility fraud is defined in R.C. 2913.401(B): {¶37} “(B) No person shall knowingly do any of the following in an application for enrollment in the medicaid program or in a document that requires a disclosure of assets for the purpose of determining eligibility…”
Ohio Rev. Code § 2913.401(B): 1 case
State v. Mahvi, 2018-Ohio-4944. “{¶36} Medicaid eligibility fraud is defined in R.C. 2913.401(B): {¶37} “(B) No person shall knowingly do any of the following in an application for enrollment in the medicaid program or in a document that requires a disclosure of assets for the purpose of determining eligibility…”
Ohio Rev. Code § 2913.401(B)(1): 3 cases
State v. Rivarde, 966 N.E.2d 301 (Ohio Ct. App. 2011). “” {¶ 5} In her single assignment of error, appellant initially argues that her conviction was improper because she could not be charged and convicted “under a general statute, like tampering with records, where a specific statute applies,” namely, falsification in violation of R.”
Smith v. Smith, 2019-Ohio-129, 128 N.E.3d 914. “See R.C. 2913.401(B)(1) ("No person shall knowingly[,] * * * in an application for enrollment in the medicaid program or in a document that requires a disclosure of assets for the purpose of determining eligibility for the medicaid program[,] [m]ake or cause to be made a false…”
State v. Mahvi, 2018-Ohio-4944. “{¶36} Medicaid eligibility fraud is defined in R.C. 2913.401(B): {¶37} “(B) No person shall knowingly do any of the following in an application for enrollment in the medicaid program or in a document that requires a disclosure of assets for the purpose of determining eligibility…”
Ohio Rev. Code § 2913.401(C)(3): 1 case
State v. Rivarde, 966 N.E.2d 301 (Ohio Ct. App. 2011). “” {¶ 5} In her single assignment of error, appellant initially argues that her conviction was improper because she could not be charged and convicted “under a general statute, like tampering with records, where a specific statute applies,” namely, falsification in violation of R.”
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