Insurance and Health Care Fraud

Articles 176 and 177, which cover insurance and health fare Fraud respectively, very closely mirror each other. They each provide five degrees of crimes, ranging from class A misdemeanor to class B felony, for those that knowingly and with intent to defraud provide false information or conceal information and thereby take, obtain or withhold (or attempts to take, obtain or withhold) property from an insurance plan or health care plan, respectively. If the property fraudulently obtained (or attempted to be obtained) is worth less than $1000, then the fifth-degree class A misdemeanor charge applies; fourth-degree is for $1,000, third-degree is for $3,000, second-degree is for $50,000, and first-degree is for $1,000,000.

Key Penal Law Provisions:

  • Insurance fraud in the fifth degree, P. L. 176.10, a class A misdemeanor
  • Insurance fraud in the fourth degree, P. L. 176.15, a class E felony
  • Insurance fraud in the third degree, PL 176.20, a class D felony
  • Insurance fraud in the second degree, PL 176.25, a class C felony
  • Insurance fraud in the first degree, PL 176.30, a class B felony
  • Health care fraud in the fifth degree, PL 177.05, a class A misdemeanor
  • Health care fraud in the fourth degree, PL 177.10, a class E felony
  • Health care fraud in the third degree, PL 177.15, a class D felony
  • Health care fraud in the second degree, PL 177.20, a class C felony
  • Health care fraud in the first degree, PL 177.25, a class B felony