Arkansas § 5-37-217 Healthcare fraud

Arkansas Statutes

§ 5-37-217 — Healthcare fraud

Arkansas § 5-37-217

Title5

This text of Arkansas § 5-37-217 (Healthcare fraud) is published on Counsel Stack Legal Research, covering Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ark. Code Ann. § 5-37-217 (2026).

Text

(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 j

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