Arizona Governor Katie Hobbs and state officials are combating Medicaid fraud, focusing on illegitimate group homes.

Medicaid Fraud in Group Homes

Arizona Governor Katie Hobbs and state officials have announced a rigorous campaign to curb Medicaid fraud, focusing on illegitimate group homes. Governor Hobbs’ administration says many of these fraudulent homes specifically target tribal community members, resulting in substantial financial losses for the state.

The investigative efforts, involving collaboration with the FBI and the U.S. Attorney’s Office, have led to the indictment of at least 45 individuals by Arizona Attorney General Kris Mayes.

A staggering $75 million tied to these fraudulent schemes has been seized or recovered through these indictments.

False Claims to Medicaid

The funds in question were disbursed by the state’s Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS). The fraudulent activities primarily involve submitting false claims for mental health treatment and addiction rehabilitation services that were never rendered.

AHCCCS has responded by suspending payments to over 100 providers, with further suspensions expected in the upcoming months. Authorities unveiled a series of new initiatives to combat fraud effectively. These include a comprehensive third-party forensic audit that will scrutinize mental health and addiction provider claims dating back to 2019.

The state also plans to implement more robust procedures for identifying concerning or irregular claims while revamping its fraud detection methods.

Governor Hobbs Targets Fraud

Governor Hobbs emphasized the need for systemic reforms to tackle this pressing issue, stating, “Prior to my administration, AHCCCS had taken a piecemeal approach to targeting these fraudulent providers. Under my administration, this will change… Together, we are going to bring about the systemic reforms we need to root out this problem and deliver true accountability.”

Daniel Scarpinato, former Chief of Staff for Governor Doug Ducey, voiced his criticism regarding the timing of the crackdown’s announcement. He argued, “The investigation revealed today has been underway for several years, well before the current occupants took office.”

Governor Hobbs and Attorney General Mayes made the joint announcement during a press conference that featured representatives from 13 tribes across the state.

The collaborative effort highlighted the commitment of both state and tribal authorities to combat Medicaid fraud and protect their communities interests.

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