Two wrongful death lawsuits have been filed against the state of Arizona for alleged mismanagement of sober living homes that led to the deaths of Indigenous men.
Investigators into the sober living home fraud scandal have said that Indigenous people were targeted for their unique payer status and social vulnerability. Under the...
And medical device manufacturers and durable medical equipment suppliers accounted for more civil settlements and judgments for medical and support services Medicaid fraud in FY 2023, according to Medicaid Fraud Control Units (MFCUs) that investigate and prosecute Medicaid provider fraud and patient abuse or neglect.
Settlements &...
More fraudulent sober living home operators were charged by the state of Arizona this week for patient referral kickback schemes. Arizona Health Care Cost Containment System (AHCCCS) Cabinet Executive Officer Carmen Heredia is calling for an overhaul of the state Medicaid system after spending the first year of her position focusing on...Arizona News
The Arizona Attorney General's Office is continuing its massive investigation into fraudulent substance abuse recovery homes that target Native Americans.
Last week, the AG's office announced that the Better You Wellness Center LLC's two owners and its biller were indicted on charges of fraudulently billing the Arizona Health Care...Arizona News
Hundreds of people are being left homeless after the rapid closure of sober living homes across the state, following an investigation into addiction recovery facilities that sought to defraud the Arizona Health Care Cost Containment System (AHCCCS) and target Native Americans.
A large sober living facility, Ocotillo Apartments and...
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...
Last Wednesday, the Centers for Medicare and Medicaid Services (CMS) announced proposed payment policy changes for the Medicare Advantage and Part D programs for Calendar Year (CY) 2023. The proposal includes a 7.98% payment increase and health equity provisions for MA participation, for example in star ratings.
The advance notice was...
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...
On Tuesday, Feb. 5, former Hacienda Healthcare nurse Nathan Sutherland pleaded not guilty for raping and impregnating a disabled 29-year-old woman in a vegetative state for nearly two decades. Sutherland was arrested last month after the woman unexpectedly gave birth to a baby boy on Dec. 29.
The unprecedented birth in December...National News
To crack down on Medicaid fraud and waste, The Centers for Medicare & Medicaid Services (CMS) will conduct audits of state programs and private Medicaid managed care plans as part of an initiative announced Tuesday, June 26.
CMS administrator Seema Verma attributed these plans to the agency's reformation of Medicaid for "a...