The Helping Enhance Access to Rural Treatment (HEART) Act aims to provide an income tax incentive for donations to rural hospital organizations in Arkansas. It establishes a new subchapter under Arkansas Code Title 20, Chapter 12, defining terms such as "critical access hospital," "rural county," and "rural hospital organization." The bill sets criteria for these organizations to qualify for contributions, including financial viability and participation in Medicaid and Medicare. The Department of Health will create a list of eligible organizations and develop an operations manual to rank them based on financial need. Additionally, the bill amends Arkansas Code Title 26, Chapter 51, to introduce a tax credit for contributions to approved rural hospital organizations, with varying credit amounts based on contributor status and annual limits.

The bill also includes provisions that allow taxpayers to claim a credit for contributions even if the organization fails to meet certain reporting requirements, as long as the contribution was preapproved by the Department of Finance and Administration. A letter of confirmation from the rural hospital organization detailing the contribution must be attached to the taxpayer's return. To ensure transparency, the Department of Finance and Administration is required to post relevant information on its website, and an annual audit by the Department of Inspector General is mandated to maintain accountability in the tax credit program. These provisions will take effect for tax years beginning on or after January 1, 2025.