Arizona is advancing a major overhaul of its Medicaid infrastructure, with new milestones in its AHCCCS MES modernization effort focused on data exchange and program integrity. AHCCCS also plans to roll out a new customer service system next month. The modernization effort is part of a broader initiative to replace legacy systems,...Arizona News
AHCCCS is moving into the next phase of its multi-year Medicaid Enterprise System (MES) modernization effort, an overhaul that began in 2019 to improve provider operations and strengthen program integrity across the agency’s technology platforms.
The agency said the upgrades are designed to make it easier, faster, and more secure...Arizona News
This week an Arizona man has been sentenced to 3.5 years in prison for illegally attempting to profit from the state’s Medicaid program by brokering access to behavioral health services in exchange for kickbacks.
Corey Dion Beckhum was convicted June 26 of one count of Conspiracy to Commit Consideration for Patient Referral and one...
Federal prosecutors have charged seven individuals in Arizona in connection with alleged schemes to defraud Medicare and the Arizona Health Care Cost Containment System (AHCCCS) as part of the U.S. Department of Justice’s 2025 National Health Care Fraud Takedown. The coordinated enforcement action includes charges against 324...
BerryDunn, a forensic accounting and auditing firm, was contracted by the Arizona Health Care Cost Containment System (AHCCCS) in April 2023 to complete auditing, analysis, compliance review, and assessment services, focused primarily on behavioral health care services provided to American Indian (AI) and Alaska Native (AN)...Arizona News
The Arizona Republic continued its reporting this week with several stories that dig deeper into when the agency learned of unscrupulous actors billing the agency, the players who perpetrated the scheme and those who suffered most, the patients and families of the tribal members victimized by the fraud. Arizona Attorney General Mayes...Arizona News
On December 28, the Arizona Center for Investigative Reporting found that the state's Medicaid agency, the Arizona Health Care Cost Containment System (AHCCCS) was informed in August 2022 that the agency's billing reforms for behavioral health providers "will have the unintended consequence of adding a significant amount of homeless to...Arizona News
As the state crackdown on fraudulent Medicaid-funded substance abuse recovery homes across Arizona continues, stories of patients impacted by the programs are emerging.
The facilities would operate under generic names like "Healing Fountain," "Happy Valley," or "Angelic Behavioral Health," and registered with the state as counseling...
The Arizona Health Care Cost Containment System (AHCCCS) is reminding enrollees and other members of the public to report any suspicious activity when promised healthcare, residential services or transportation to such services - the agency is concerned that American Indians/Alaskan Natives on tribal lands are especially...
Across the county, accusations of fraud related to Medicare, Medicaid, and Medicaid Advantage have increased and Arizona has not escaped involvement. While, nationally, complaints against Kaiser Permanente and UnitedHealthcare have been filed or escalated, in Arizona, 27 individuals and business entities have been indicted on criminal...
Several healthcare fraud cases have advanced or resolved this month, including the case of Elizabeth Holmes, who got state lawmakers and Governor Doug Ducey to change Arizona law in 2015 to financially benefit her company.
Holmes goes to trial this week on charges of fraud and conspiracy after she “knowingly misrepresented the...
This week, a Tucson man received 27 months behind bars and fined more than $100,000 for submitting false transportation records and a woman who faked cancer to get AHCCCS to pay for her abortion will get 10 years in prison.
In October 2017, the Fraud Division of the Pima County Sheriff’s Office responded to a report of internal...
