Arizona to Shut Down Over 100 Fraudulent Healthcare Providers

Phoenix — Arizona has a problem. Illegal group homes may be exploiting vulnerable Native Americans to defraud states of hundreds of millions of dollars in federal funds.

On Tuesday, Gov. Katie Hobbs and Attorney General Chris Mays announced an immediate suspension of Arizona Health Care Cost Control System (AHCCCS) payments to more than 100 fraudulent health care providers.

The exact extent of the scam remains unclear, but Governor Hobbes estimates the number of people taken advantage of is in the thousands. Mays called the issue one of the biggest scandals in Arizona history.

Related: Police Investigate Indigenous People ‘Recruited’ To Move To Phoenix Rehab Center

These scam providers purportedly recruit endangered Native Americans. Mays explained that they would encourage vulnerable people to participate in “treatment” at outpatient clinics, promising food, cash payments or rent subsidies.

Once there, the patient was pressured to enroll with AHCCCS to pay for the treatment, but the treatment was far from what was promised. Often it never arrives.

Instead, people were often placed in group homes stocked with drugs and alcohol and cut off from their families. Hobbs explained that people often had to jump over fences at night just to access their phones to call their loved ones for help.

All the while, providers were pulling funds out of the Medicaid system. [the patient] We overcharged AHCCCS for treatment services that AHCCCS did not provide or were grossly misrepresented,” Mays said.

In some cases, these families may charge AHCCCS for people they have not even been in contact with, officials said. Fraudulent services were being billed against people who were found dead, incarcerated, or living in another state.

During the investigation, the state found that the 4-year-old allegedly received 13 hours of alcohol rehabilitation counseling per day. Mays stressed that this could never happen in real life.

“It’s been a whack-a-mole,” Mays said of the process of closing these homes. Mays accused the Ducey administration of ignoring the issue and failing to reform the system.

“At least hundreds of millions of dollars have been lost to these scams, but the impact could be much greater,” Mays said. “This should never have been allowed. The previous administration was dozing off with the switch on, sleeping at the wheel.”

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In response to fraudulent activity, AHCCCS has made some major changes. Starting in 2017, they plan to conduct third-party forensic audits of all claims, introduce a new reporting system for AHCCCS claims that raise concerns, and pursue new methods of fraud prevention.

Solari Crisis Welfare Services has put in place a hotline for those affected by the closure of behavioral health and sobriety facilities. Please call. 2-1-1 and select Option 7.

Officials say this is just the first step in rooting out abuse fraud by opportunistic providers.

“It’s going to be a battle, but it’s a battle that the administration and I are going all in,” Hobbes said.

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