Arizona’s Medicaid agency identified significant concerns regarding the data submitted by HCA as well as, “HCA’s lack of attention to, and focus on,” the audit, which was used to evaluate immunizations to members before age 2 in compliance with childhood immunization reporting requirements.
It’s not the first time AHCCCS has penalized HCA for noncompliance in its reporting. In January 2018, AHCCCC was sanctioned $25,000 for its failure to comply with accuracy and completeness standard during the agency’s CYE 2015 Diabetes hybrid audit.
The most recent penalty assessed against HCA is a result of the insurer’s submission in 2017 of data to comply with the AHCCCS’ 2017 Childhood Immunization Audit. The agency charged HCA with submitting inaccurate and unreliable data that contained material omissions and “was not responsive to the AHCCCS request.”
“It’s imperative that HCA immediately address and implement improvements to its processes for meeting accuracy and completeness standards for all future AHCCCS required audits,” stated AHCCCS in its letter to HCA CEO Shawn Nau on September 17, 2018.
Click here to read the letter from AHCCCS to HCA