AHCCCS News & Updates 
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FOR IMMEDIATE RELEASE
May 16, 2024

AHCCCS Makes Strides, Reforms Agency in Response to Sober-Living Fraud


Ensuring member safety and access to needed health care services is top priority as agency evolves to prevent fraud


PHOENIX -- Today, the Arizona Health Care Cost Containment System (AHCCCS) detailed agency progress in response to member exploitation and fraud committed by bad actors across the state.

In May 2023, AHCCCS announced its initial findings of credible and willful fraud by sober-living providers across the state. Those findings pointed to blatant and intentional exploitation of members and government programs and resulted in more than 100 suspensions. Since then, AHCCCS has suspended an additional 200 providers, totaling more than 300 suspensions over the past year. Along with the Arizona Attorney General and other law enforcement agencies, AHCCCS has dedicated significant resources to respond to this issue and create a proactive plan to ensure that it does not happen again.

“Our top priority is ensuring AHCCCS members are safe,” said Carmen Heredia, AHCCCS cabinet executive officer. “While focusing on member impact and humanitarian response efforts, terminations and exclusions of bad actors have been at the forefront of agency changes. With support from the Governor’s Office, Tribal Leaders, providers, and sister state agencies, AHCCCS has made great progress through agency reforms.”

Updates on the continuing fraud detection and response shared during today’s media briefing call included:

“We are committed to evolving this agency to meet the needs of the more than two million Arizonans we serve, and our priority remains on health equity, access to care, quality care and the elimination of fraud in our program,” Heredia said.

A public video of CEO Heredia highlighting the agency’s year in review efforts is available on the AHCCCS YouTube channel.

Please visit azahcccs.gov/soberlivingfraud for the content covered during today’s press call as well as resources and more information.

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