Arkansas Code of 1987 (2023) › Title 5 - CRIMINAL OFFENSES (§§ 5-1-101 — 5-79-101) › Subtitle 5 - OFFENSES AGAINST THE ADMINISTRATION OF GOVERNMENT (§§ 5-51-201 — 5-56-101) › Chapter 55 - FRAUD AGAINST THE GOVERNMENT (§§ 5-55-101 — 5-55-602) › Subchapter 1 - MEDICAID FRAUD ACT (§§ 5-55-101 — 5-55-115) › Section 5-55-104 - Records

(a)
No potential Medicaid recipient is eligible for medical assistance unless he or she has authorized in writing the Secretary of the Department of Human Services to examine all records of the potential Medicaid recipient's own, or of those receiving or having received Medicaid benefits through him or her, whether or not the receipt of the benefits would be allowed by the Arkansas Medicaid Program, for the purpose of investigating whether any person may have committed the crime of Medicaid fraud or for use or potential use in any legal, administrative, or judicial proceeding.
(b)
No person is eligible to receive any payment from the Arkansas Medicaid Program or its fiscal agents unless the person has authorized in writing the secretary to examine all records for the purpose of investigating whether any person may have committed the crime of Medicaid fraud or for use or for potential use in any legal, administrative, or judicial proceeding.
(c)
The Attorney General and the prosecuting attorneys are allowed access to all records of persons and Medicaid recipients under the Arkansas Medicaid Program to which the secretary has access for the purpose of investigating whether any person may have committed the crime of Medicaid fraud or for use or potential use in any legal, administrative, or judicial proceeding.
(d)
Notwithstanding any other law to the contrary, no person is subject to any civil or criminal liability for providing access to records to the secretary, the Attorney General, or the prosecuting attorneys.
(e)
Records obtained by the secretary, the Attorney General, or the prosecuting attorneys pursuant to this subchapter are classified as confidential information and are not subject to outside review or release by any individual except when records are used or potentially to be used by any government entity in any legal, administrative, or judicial proceeding.
(f)
(1)
A Medicaid provider or person providing healthcare goods or services under the Arkansas Medicaid Program is required to maintain all records at least for a period of five (5) years from the date of claimed provision of any goods or services to any Medicaid recipient.
(2)
(A)
The records described in subdivision (f)(1) of this section shall be available for audit during regular business hours at the address listed in the Medicaid provider agreement or where the healthcare goods or services are provided.
(B)
Closed records for inactive patients or clients may be maintained in offsite storage if:
(i)
The records can be produced within three (3) working days of being served with a request for records, subpoena, or other lawful notice from any agency with authority to audit the records; and
(ii)
The records are maintained within the state.
(C)
A Medicaid provider shall disclose upon request the location of any offsite storage facility to any agency with authority to audit the records.
(3)
If the healthcare goods or services are provided in the home of the Medicaid recipient, the records shall be maintained at the principal place of business of the Medicaid provider.
(4)
If a Medicaid provider goes out of business, the Medicaid provider shall give written notification to the Department of Human Services and the Office of Medicaid Inspector General of where and how the records will be stored.
(g)
(1)
It is unlawful to destroy or alter any record or supporting documentation with a purpose to conceal a false or fraudulent claim made to the Arkansas Medicaid Program or to interfere with an audit, investigation, or prosecution related to a claim made to the Arkansas Medicaid Program.
(2)
A violation of subdivision (g)(1) of this section is a Class B felony.
(h)
(1)
Any person found not to have maintained any records upon conviction is guilty of a Class D felony if the unavailability of records impairs or obstructs the prosecution of a felony.
(2)
Otherwise, a violation of subdivision (h)(1) of this section is a Class A misdemeanor.
(i)
It is an affirmative defense to a prosecution under this section that the records in question were lost or destroyed in a flood, fire, or other natural disaster or by a criminal act that did not result from the defendant's conduct.
Amended by Act 2019, No. 910,§ 5127, eff. 7/1/2019.
Amended by Act 2017, No. 978,§ 4, eff. 8/1/2017.
Acts 1979, No. 823, § 10; A.S.A. 1947, § 41-4410; Acts 1993, No. 1291, §§ 3, 7.