§ 5-55-102 - Definitions. - Arkansas Statutes

5-55-102. Definitions.

As used in this subchapter:

(1) "Arkansas Medicaid Program" means the program authorized under Title XIX of the Social Security Act, 42 U.S.C. 1396 et seq., provides for payments for medical goods or services on behalf of indigent families with dependent children and of aged, blind, or disabled individuals whose income and resources are insufficient to meet the cost of necessary medical services;

(2) "Claim" means any written or electronically submitted request or demand for reimbursement made to the Arkansas Medicaid Program by any provider or its fiscal agents for each good or service purported to have been provided to any medicaid recipient whether or not the State of Arkansas provides any or no portion of the money that is requested or demanded;

(3) "Fiscal agents" means any individual, firm, corporation, professional association, partnership, organization, or other legal entity that, through a contractual relationship with the Department of Health and Human Services and, thereby, the State of Arkansas receives, processes, and pays claims under the Arkansas Medicaid Program;

(4) "Medicaid recipient" means any individual in whose behalf any person claimed or received any payment from the Arkansas Medicaid Program or its fiscal agents, whether or not the individual was eligible for benefits under the Arkansas Medicaid Program;

(5) "Person" means any:

(A) Provider of goods or services under the Arkansas Medicaid Program or any employee of the provider, whether the provider be an individual, individual medical vendor, firm, corporation, professional association, partnership, organization, or other legal entity; or

(B) Individual, individual medical vendor, firm, corporation, professional association, partnership, organization, or other legal entity, or any employee of any individual, individual medical vendor, firm, corporation, professional association, partnership, organization, or other legal entity, not a provider under the Arkansas Medicaid Program but that provides goods or services to a provider under the Arkansas Medicaid Program for which the provider submits claims to the Arkansas Medicaid Program or its fiscal agents; and

(6) "Records" means all documents including, but not limited to, medical documents and X rays, developed by any person through the claimed provision of any goods or services to any medicaid recipient.