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Commission provisionally ranks new medical‑assistance fraud statute; creates high‑loss tiers
Summary
The commission adopted staff recommendations to map a new medical‑assistance fraud statute into existing theft‑related severity tiers, with a $100,000 threshold treated as an inflation‑adjusted successor to a prior $35,000 tier and higher tiers up to $1M and beyond; the motion passed after debate (9–2).
The Sentencing Guidelines Commission provisionally ranked a newly enacted medical‑assistance fraud statute on June 4, mapping its penalty tiers into the guidelines and treating a new $100,000 loss threshold as roughly the inflation‑adjusted successor to the prior $35,000 tier.
Director Wrights explained the statute repealed an earlier medical‑assistance fraud provision and created multiple alternate ways to commit the offense (including a provision similar to aggravated forgery). Statutory penalties include a 10‑year base felony, a 20‑year tier for losses at $100,000–<$1,000,000, and a top tier for losses at or above $1,000,000. Staff recommended mapping the base conduct to severity level two (aligning with prior lower tiers) and placing larger‑loss tiers at higher severity levels. In recommending a mapping, staff noted the legislature did not include an intermediate penalty tier the commission had sought; staff therefore treated the $100,000 tier as an inflation‑adjusted successor to prior thresholds.
Commissioners discussed charging practice (aggregation of loss over a continuing offense) and potential aggregation implications for sentencing. Some commissioners flagged that the absence of an intermediate tier reduces the commission's ability to make fine distinctions between small‑scale and large‑scale fraud; staff said public comment at the July hearing could prompt adjustments. The motion to adopt staff recommendations passed 9–2.
The proposed rankings and explanatory materials will be published for the July public hearing and final action the following week.
