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Ark. Code Ann. § 5-37-217

Healthcare fraud

Acts 2013, No. 1499, § 1; 2017, No. 978, § 1.

(1) As used in this section, “healthcare plan” means a publicly or privately funded program or organization that is formed to provide or pay for healthcare goods or services, including without limitation: Health insurance plans;

(2) Managed care organization plans;

(3) Risk-based provider plans;

(4) The Arkansas Medicaid Program;

(5) The Social Security Disability Insurance program; and

(6) The Medicare program.

(7) A person commits healthcare fraud if, with a purpose to defraud a healthcare plan, the person provides materially false information or omits material information in support of: An application for membership or eligibility for a healthcare plan;

(8) A claim for payment or reimbursement as a member or provider in a healthcare plan; or

(9) A prior claim for payment or to justify payments previously received from a healthcare plan for healthcare goods or services during the course of an audit or investigation conducted by the Office of Medicaid Inspector General or a healthcare oversight agency with jurisdiction to audit, investigate, or prosecute any form of healthcare fraud.

(10) Healthcare fraud is a: Class A misdemeanor if the aggregate amount of the healthcare fraud in any period of twelve (12) months is less than two thousand five hundred dollars ($2,500);

(11) Class C felony if the aggregate amount of the healthcare fraud in any period of twelve (12) months is two thousand five hundred dollars ($2,500) or more but less than five thousand dollars ($5,000);

(12) Class B felony if the aggregate amount of the healthcare fraud in any period of twelve (12) months is five thousand dollars ($5,000) or more but less than twenty-five thousand dollars ($25,000); and

(13) Class A felony if the aggregate amount of the healthcare fraud in any period of twelve (12) months is twenty-five thousand dollars ($25,000) or more.

Current official text: Arkansas General Assembly. Digitized from the UniCourt Code Improvement Commission public-domain capture. Reproduced from public-domain Arkansas statutes; confirm against the official source for the current text. Not legal advice.