SB564 Summary

• Clarifies healthcare fraud definition to apply to all healthcare plans (including health insurance, managed care, Medicaid, Medicare, and Social Security Disability Insurance) rather than just single health plans

• Restructures healthcare fraud sentencing with tiered felony classifications based on 12-month aggregate fraud amounts: Class A misdemeanor (under $2,500), Class C felony ($2,500-$4,999), Class B felony ($5,000-$24,999), and Class A felony ($25,000+)

• Updates Medicaid fraud statutes to expand criminal acts constituting fraud, including false statements, unauthorized charges, kickbacks, document falsification, and false medical entries

• Establishes mandatory restitution to Arkansas Medicaid Program Trust Fund and allows Attorney General concurrent jurisdiction to collect fines and restitution; eliminates waivable mandatory fines in civil cases and replaces civil penalty scheme with restitution-based framework

• Amends Medicaid Fraud False Claims Act (§20-77-902) to broaden scope of actionable conduct, conform definitions to federal False Claims Act standards, and clarify record retention requirements for Medicaid providers