Arizona has been grappling with a significant Medicaid fraud and human trafficking crisis, particularly targeting Native Americans. The fraud primarily involved behavioral health providers exploiting lax AHCCCS staff oversight of the fee-for-service American Indian Health Plan.
Lax staff oversight allowed unscrupulous operators to enroll as Medicaid providers without proper oversight. Some providers even forged signatures of licensed healthcare professionals to submit fraudulent claims.
One of the major issues was the manipulation of billing codes. During the Ducey administration AIHP reimbursed up to $1,400 per day for addiction treatment services. Fraudulent operators exploited this high reimbursement rate by billing for services that were either not provided or grossly inflated. This led to a surge in Medicaid payouts, straining the system and costing taxpayers hundreds of millions of dollars.
The impact on Native American communities has been devastating. Many individuals seeking help for addiction were lured away from their homes under false pretenses, only to be abandoned once the fraudulent providers were shut down. This has led to an increase in homelessness and a lack of access to legitimate healthcare services for those most in need.
Arizona Republic journalists Stephanie Innes, Arlyssa Becenti, Richard Ruelas, Lane Sainty and others have been investigating the fraud and human trafficking for more than a year, trying to get public records requests filled and piecing together the factors and lax staff oversight that led to this tragic and expensive crisis.
I encourage you to read the developing series on azcentral below:
Arizona Republic Series: A SOBERING SCANDAL
The victims | Timeline | Inside the scam | Arizona’s failure | Rebuilding trust
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