44-5,125. Workers compensation fraud and other acts or practices constituting crimes; penalties; repayment of certain amounts, interest; cause of action, certain monetary damages.
44-5,125
44-5,125. Workers compensation fraudand other acts or practicesconstituting crimes; penalties; repayment of certain amounts, interest; causeof action, certain monetary damages.(a) (1) Any person who obtains or attempts to obtain workers compensationbenefits for suchperson or another, or whodenies or attempts todeny the obligation to make any payment of workers compensation benefits byknowingly orintentionally:(A) Making a false or misleading statement,(B) misrepresenting or concealing a material fact,(C) fabricating, altering, concealing or destroying a document; (D)receiving temporary total disability benefits or permanent totaldisability benefits to which they are not entitled, while employed, or (E)conspiring withanother person to commit any act describedby paragraph (1) of this subsection (a), shall be guilty of:
(i) A class A nonperson misdemeanor, if the amountreceived as a benefit or other payment under the workers compensation act as aresult of such act or the amount that the person otherwise benefited monetarilyas a result of a violation of this subsection (a) is $1,000or less;
(ii) a severity level 9, nonperson felony, if such amount ismore than $1,000 but less than $25,000;
(iii) a severity level 7, nonperson felony, if the amount is more than$25,000, but less than $50,000;
(iv) a severity level 6, nonperson felony if the amount is more than$50,000,but less than $100,000; or
(v) a severity level 5, nonperson felony if the amount is more than$100,000.
(b) Any person who knowingly and intentionally presents a false certificateof insurance that purports that the presenter is insured under the workerscompensation act, shall be guilty of a level 8, nonperson felony.
(c) A health care provider under the workers compensation act who knowinglyand intentionally submits a charge for health care that was not furnished,shall be guilty of a level 9, nonperson felony.
(d) Any person who obtains or attempts to obtain a more favorable workerscompensation insurance premium rate than that to which the person is entitled,who prevents, reduces, avoids or attempts to prevent, reduce or avoid thepayment of any compensation under the workers compensation act, or who fails tocommunicate a settlement offer or similar information to a claimant under theworkers compensation act, by, in any such case knowingly or intentionally: (1)Making a false or misleading statement; (2) misrepresenting or concealing amaterial fact; (3)fabricating, concealing or destroying adocument; or (4) conspiring with another person or persons to commit the actsdescribed in clause (1), (2) or (3) of this subsection shall be guilty of alevel 9, nonpersonfelony.
(e) Any person who has received any amount of money as a benefitor otherpayment under the workers compensation act as a result of a violation ofsubsection (a) or (c) and any person who has otherwise benefited monetarilyas aresult of a violation of subsection (a) or (c) shall be liable to repay anamountequal to the amount so received by such person or the amount by which suchperson has benefited monetarily, with interest thereon. Anysuch amount, plus any accrued interest thereon, shall bear interest at thecurrent rate of interest prescribed by law for judgments under subsection(e)(1) of K.S.A. 16-204 and amendments thereto per month or fraction of a monthuntil repayment of such amount, plus any accrued interest thereon. Theinterest shall accrue from the date of overpayment or erroneous payment of anysuch amount or the date such person benefited monetarily.
(f) Any person aggrieved by a violation of subsection (a),(b), (c) or (d) shall have a causeof action against any other person to recover any amounts of money erroneouslypaid as benefits or any other amounts of money paid under the workerscompensation act, and to seek relief for other monetary damages, for whichliability has accrued under this section against such other person.Relief under this subsection is to be predicated upon exhaustion ofadministrative remedies available in K.S.A. 44-5,120 and amendments thereto.
(g) Nothing in this section shall prohibit an employer fromexercising aright to reimbursement under K.S.A. 44-534a, 44-556 or 44-569a and amendmentsthereto.
(h) Prosecution for any crime under this section shall be commenced withinfive years subject to the time period setforth in subsection (8) of K.S.A. 21-3106 and amendmentsthereto.
History: L. 1993, ch. 286, § 6;L. 1994, ch. 291, § 75;L. 1996, ch. 79, § 16;L. 1997, ch. 125, § 20;L. 1998, ch. 114, § 8;L. 2000, ch. 160, § 24;L. 2006, ch. 194, § 31; May 25.