{"data":{"id":"us-ar/ark.-code-ann.-5-37-217","jurisdiction":"us-ar","citation":"Ark. Code Ann. § 5-37-217","heading":"Healthcare fraud","body":"(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. Amended by Act 2017, No. 978,§ 1, eff. 8/1/2017. Added by Act 2013, No. 1499,§ 1, eff. 7/1/2013.\n\n(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.\n\n(1) Health insurance plans;\n\n(2) Managed care organization plans;\n\n(3) Risk-based provider plans;\n\n(4) The Arkansas Medicaid Program;\n\n(5) The Social Security Disability Insurance program; and\n\n(6) The Medicare program.\n\n(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.\n\n(1) An application for membership or eligibility for a healthcare plan;\n\n(2) A claim for payment or reimbursement as a member or provider in a healthcare plan; or\n\n(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.\nent as a member or provider in a healthcare plan; or\n\n(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.\n\n(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.\n\n(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);\n\n(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);\n\n(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\n\n(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.","path":["AR Code","Title 5","Chapter 37","Subchapter 2"],"source_url":"https://oss-data-us.vaquill.ai/v2026.08/us_ar_statutes.parquet","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:41Z","sha256":"303f0cdd285c343bfcbfae3e1a1da5e1f15ce5ca5dbc1cc3d53e8f335af67e1d","source_id":"us-ar","stale":false,"prev":"us-ar/ark.-code-ann.-5-37-216","next":"us-ar/ark.-code-ann.-5-37-218"},"notice":"GroundRules: Original legal text. Not legal advice."}