An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in fraud and abuse control, further providing for definitions and for provider prohibited acts, criminal penalties and civil remedies.

HB 216 amends Pennsylvania's Human Services Code to strengthen fraud and abuse controls in the medical assistance program (Medicaid). It adds a definition of "Representation" to clarify communications used for billing or determining reimbursement rates, and updates prohibited acts to explicitly include making false or misleading statements in claims or records. The bill expands specific prohibitions to cover submitting claims for medically unnecessary services, misrepresenting services provided, or billing for non-rendered care. These changes directly affect healthcare providers and practitioners who bill the state's Medicaid program by providing clearer standards for compliance. The amendments aim to improve enforcement of existing penalties without creating new ones.