AZ auditor general: AHCCCS is not sufficiently investigating fraud cases

By Greg Hahne
Howard Fischer/Capitol Media Services
Published: Monday, October 3, 2022 - 2:18pm

The state Auditor General’s Office has found Arizona’s Medicaid program is not sufficiently investigating potential cases of fraud.

A new report found that AHCCCS has taken more than a year to initiate or complete preliminary investigations for more than a half of its potential fraud and abuse cases. 

While Auditor General Lindsey Perry says the state has recovered nearly 50 million in the last fiscal year, it may still be paying to provide coverage for people who obtained it fraudulently.

Though the problem is not limited to patients. The report found that almost 90% of preliminary investigations into provider fraud were not completed within three months. That’s the time frame established between AHCCCS and the Auditor’s Office. 

AHCCCS has said part of the problem was the pandemic and high staff turnover.