(1) In a prosecution under this act, it shall not be necessary to show that the person had knowledge of similar acts having been performed in the past by a person acting on the person’s behalf, nor to show that the person had actual notice that the acts by the persons acting on the person’s behalf occurred, to establish the fact that a false statement or representation was knowingly made.
(2) It shall be a rebuttable presumption that a person knowingly made a claim for a health care benefit if the person’s actual, facsimile, stamped, typewritten, or similar signature is used on the form required for the making of the claim for the health care benefit.
Terms Used In Michigan Laws 752.1007
- Claim: means any attempt to cause a health care corporation or health care insurer to make the payment of a health care benefit. See Michigan Laws 752.1002
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- False: means wholly or partially untrue or deceptive. See Michigan Laws 752.1002
- Health care benefit: means the right under a contract or a certificate or policy of insurance to have a payment made by a health care corporation or health care insurer for a specified health care service. See Michigan Laws 752.1002
- Health care corporation: means a nonprofit dental care corporation incorporated under Act No. See Michigan Laws 752.1002
- Health care insurer: means any insurance company authorized to provide health insurance in this state or any legal entity which is self-insured and providing health care benefits to its employees. See Michigan Laws 752.1002
- in writing: shall be construed to include printing, engraving, and lithographing; except that if the written signature of a person is required by law, the signature shall be the proper handwriting of the person or, if the person is unable to write, the person's proper mark, which may be, unless otherwise expressly prohibited by law, a clear and classifiable fingerprint of the person made with ink or another substance. See Michigan Laws 8.3q
- knowingly: means that a person is in possession of facts under which he or she is aware or should be aware of the nature of his or her conduct and that his or her conduct is substantially certain to cause the payment of a health care benefit. See Michigan Laws 752.1002
- Person: means an individual, corporation, partnership, association, or any other legal entity. See Michigan Laws 752.1002
(3) If a claim for a health care benefit is made by means of computer billing tapes or other electronic means, it shall be a rebuttable presumption that the person knowingly made the claim if the person has advised the health care corporation or health care insurer in writing that claims for health care benefits will be submitted by use of computer billing tapes or other electronic means.
(4) In any civil or criminal action under this act the certificate of an authorized agent of the health care corporation or health care insurer setting forth that documentary material or any compilation thereof is an authentic record or compilation of records of the health care corporation or health care insurer shall create a rebuttable presumption that the record or compilation is authentic.