5-37-217. Healthcare fraud.

Arkansas Code — all titles (historical 2020) · legal_authorities

5-37-217. Healthcare fraud.

5-37-217. Healthcare fraud. (a) 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: (1) 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. (b) 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: (1) An application for membership or eligibility for a healthcare plan; (2) A claim for payment or reimbursement as a member or provider in a healthcare plan; or (3) 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. (c) Healthcare fraud is a: (1) 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); (2) 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); (3) 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 (4) Class A felony if the aggreg

Source: Arkansas Code — historical release 78 (November 6, 2020) · 5-37-217

Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. A text match is a research starting point; applicability is not established.