You Can Help Stop Medicaid Fraud, Waste, and Abuse

The Office of Inspector General (OIG) investigates reports of suspected fraud, waste, and abuse of AHCCCS programs. Each year, OIG recovers and saves tens of millions of dollars in fraudulent claims from members and providers against Medicaid.

In SFY19, OIG recovered and saved more than $52.6M.

The primary way AHCCCS discovers fraud is through referrals from people like you. 

What does fraud look like?

Fraud is when someone lies or gives false information with the intent to receive benefits or payments for which they are not legally eligible. Members and Providers commit fraud in a variety of ways; here are just a few:  

Members

  • Provide incorrect household composition information
  • Falsify income or fail to report income 
  • Hide employment or self-employment information
  • Falsify Arizona or US residency status

Providers

  • Make false statements and false claims
  • Billing for services and supplies not provided
  • Double billing, over billing, and incorrect coding
  • Committing prescription and pharmacy fraud

If you suspect Medicaid fraud, don’t hesitate to report it. Anyone can anonymously report fraud, waste, or abuse. OIG depends on people like you–employees, members, providers and the general public to provide these referrals for investigation. 

To report possible Medicaid fraud, visit azahcccs.gov/ReportFraud

You may also submit attachments and/or additional information by email to AHCCCSFraud@azahcccs.gov.

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AHCCCS and Health Plan Partners Celebrate Native American Heritage Month

Throughout November, AHCCCS celebrates Native American Heritage Month with our tribal, community, federal, and state agency partners. Arizona is home to the varied and diverse traditions, cultures, languages, and histories of 22 federally recognized tribes. Led by the agency’s Tribal Liaison, AHCCCS leadership works in close concert with tribes to develop policies that help to decrease health disparities and increase positive health outcomes.

A unique government-to-government relationship exists between American Indian tribes and state and federal governments. This important relationship is the foundation of the work of the AHCCCS tribal liaison, Amanda Bahe, and the Division of Community Advocacy and Intergovernmental Relations as they consult with each governmental entity in regards to Medicaid service delivery within the State of Arizona. The Tribal Liaison works to implement and improve the AHCCCS Tribal Consultation Policy and facilitates meetings between AHCCCS leadership and tribal nations, Indian Health Services, and Urban Indian health facilities. 

In honoring the sovereignty of tribes, part of our role as a State Medicaid agency is ensuring that the American Indian and Alaska Native members we serve have freedom of choice among qualified health providers. American Indian and Alaska Native AHCCCS members may choose between Fee-for-Service (also known as the AHCCCS American Indian Health Program, housed in the Division of Fee for Service Management) or Managed Care health plans, and can change their choice at any time. Our agency also ensures that AHCCCS-enrolled American Indian and Alaska Native members are able to receive services from an IHS and/or tribally-owned and -operated 638 facilities at any time, regardless of their AHCCCS health plan enrollment.  

To celebrate Native American Heritage Month, we highlight the following events sponsored by AHCCCS health care plans and community partners. Please reach out to the sponsoring entity for more information.

  • November 1, First Friday at the Heard
    • Heard Museum, 2301 N. Central Ave., Phoenix, AZ 85004
  • November 2, 14th Annual Navajo Art and Rug Auction
    • Pueblo Grande Museum, 4619 E. Washington St., Phoenix, AZ 85034, 12:00 p.m. – 5:00 p.m.
  • November 2, NATIVE HEALTH Annual Bike Rodeo
  • November 6, Eco-Fashion/Costume Design Workshop
    • NATIVE HEALTH Central, 4041 N. Central Ave., Phoenix, AZ 85012, 5:00 p.m. – 8:00 p.m.
    • Email: desiree.ong@asu.edu
  • November 6, Stew and Stories
    • South Mountain Community College, 7050 S. 24th St., Phoenix, AZ 85042, 6:00 p.m. – 8:30 p.m.
  • November 7 – 8, Native American Women’s Conference
    • Wild Horse Pass Hotel & Casino, 5040 Wild Horse Pass Blvd., Chandler, AZ 85226
  • November 9, Native American Heritage Festival & 19th Annual Veterans Day Weekend Traditional Pow Wow
    • ASU West Campus, Fletcher Library Lawn, 4701 W. Thunderbird Road, Glendale, AZ 85306, 11:00 a.m. – 10:00 p.m.
  • November 9, Veterans and Weavers Marketplace
    • Heard Museum, 2301 N. Central Ave., Phoenix, AZ 85004, 11:00 a.m. – 4:00 p.m.
  • November 11, Veterans Day Gourd Dance
    • Pueblo Grande Museum, 4619 E. Washington St., Phoenix, AZ 85034, 11:00 a.m. – 4:00 p.m.
  • November 11, Veteran’s Tribute, Sunset Ceremony
    • Heard Museum, 2301 N. Central Ave., Phoenix, AZ 85004, 5:00 p.m. – 6:00 p.m.
  • November 15-17, 38th Annual Fort McDowell Orme Dam Victory Days
    • Fort McDowell Rodeo Grounds, 9500 S. Rodeo Dr., Fort McDowell, AZ 85264
  • November 16, Native American Family Health Festival
    • Phoenix Indian Medical Center, 4212 N. 16th St., Phoenix, AZ 85016
  • November 21, South Mountain Community College American Indian Art Market and Food Tasting Event
    • South Mountain Community College, 7050 S. 24th St., Phoenix, AZ 85042, 6:00 p.m. – 8:30 p.m.
  • November 29, 20th Annual Native American Children Toy Drive, Concert & Market
    • Arizona Science Center, 600 E. Washington St., Phoenix, AZ 85004, 5:00 p.m. – 9:00 p.m.

The rich histories and storied cultures of tribal nations throughout the state are handed down through art, music, and traditions shared from generation to generation. To learn more about Native American Heritage Month, visit nativeamericanheritagemonth.gov.

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American Indians are more susceptible to suicide than national average

American Indians have a higher risk of dying by suicide. Arizona is home to 22 tribal nations. Suicide is preventable.

Suicide is preventable. Those American Indians considering dying by suicide may demonstrate one of the following behaviors:

  • An increase in substance use
  • A change in sleeping pattern
  • Giving away possessions, including pets
  • Depression and withdrawal from social obligations
  • Discussing dying by suicide

If someone in your life is dealing with loss, or exhibiting one of the symptoms above, there are resources available.  We can all work to prevent suicide.

What you can do:

  • Know the cultural risk factors for suicide among American Indians, and how to refer a person to care.
  •  Consider making a safety plan for if/when you feel depressed or suicidal. A protective factor for suicide includes having a strong support network. Knowing who to call when you feel depressed or suicidal can help in crisis.
  • Practice active listening; listening to someone who is depressed or having suicidal thoughts, without offering advice or judgment, is courageous.
  • Advocate for the importance of suicide surveillance systems, including building relationships with respected community members.
  • Speak with tribal councils, school boards, and other community leaders about the need for suicide prevention resources.
  • If someone in your life is considering dying by suicide, do not leave this person alone. Remove any firearms or unnecessary prescription medications from the home. When in doubt, call 9-11.

If someone in your life is considering dying by suicide, do not leave this person alone. Remove any firearms or unnecessary prescription medications from the home. When in doubt, call 9-11.

For additional resources, visit AHCCCS.

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