Arizona Administrative Code
Title 9 - HEALTH SERVICES
Chapter 22 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ADMINISTRATION
Article 4 - PENALTY FOR OBTAINING ELIGIBILITY BY FRAUD
Section R9-22-403 - Mitigating and Aggravating Circumstances
Universal Citation: AZ Admin Code R 9-22-403
Current through Register Vol. 30, No. 38, September 20, 2024
A. AHCCCS shall consider any of the following to be mitigating circumstances when determining the amount of a penalty for obtaining eligibility by fraud.
1. Degree of
culpability. The degree of culpability of a person is a mitigating circumstance
if the person did not intend to provide or cause to be provided false
information on the application for eligibility but was negligent as to the
truthfulness of the information provided.
2. Prior Offenses. At the time of the
submittal of the application the person:
a.
Did not have any prior criminal convictions; and
b. Had not been held civilly liable for
defrauding a public assistance program.
3. Financial condition. The financial
condition of a person who violates A.R.S. §
36-2905.04
or
36-2991
is a mitigating circumstance if the imposition of a penalty without reduction
will render the person incapable of obtaining necessities of life such as food,
clothing, and shelter. AHCCCS may consider the resources available to the
person when determining the amount of the penalty.
4. Other matters as justice may require.
AHCCCS shall take into account other circumstances of a mitigating nature, if
in the interest of justice; the circumstances require a reduction of the
penalty.
B. AHCCCS shall consider any of the following to be aggravating circumstances when determining the amount of a penalty for obtaining eligibility by fraud.
1. Degree of culpability. The degree of
culpability of a person who provides or causes to be provided false information
on the application for eligibility is an aggravating circumstance if the person
knows or had reason to know that the information provided on the application
for eligibility was false, or the person failed to correct the false
information prior to AHCCCS incurring a financial loss as a result of the
application for eligibility.
2.
Prior offenses. At any time before the submittal of the application for
eligibility, the person was held criminally or civilly liable for committing
any fraud, waste, or abuse against any public assistance program.
3. Financial Loss. The person's violation of
A.R.S. §
36-2905.04
or
36-2991
caused a loss to the system equal to or exceeding $5,000.00.
4. Other matters as justice may require.
AHCCCS shall take into account other circumstances of an aggravating nature, if
in the interest of justice; the circumstances require an increase of the
penalty.
Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
