Hobbs, Mayes allege massive billing fraud in Arizona's health plan

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Hobbs, Mayes allege massive billing fraud in Arizona's health plan
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Gov. Katie Hobbs and Attorney General Kris Mayes, Democrats, claim their Republican predecessors ignored AHCCCS scams targeting Native Americans.

Howard Fischer PHOENIX — Arizona is the victim of massive fraud in its health-care program, Gov. Katie Hobbs and Attorney General Kris Mayes said Tuesday, and they blamed their Republican predecessors for ignoring it.

Mayes said scammers used the names of Native Americans — some who were dead — to bill for services never provided. But Mayes said the prosecutions of the past amounted to a"whack-a-mole'' approach of going after individual fraudsters but never recognizing, or addressing, how to prevent the problem. There even were cases where the state was billed for services she said were"impossible to render,'' such as 13 hours a day of alcohol rehab services for a 4-year-old for whom they had the child's AHCCCS identification card.

Estimate: 'Hundreds of millions' lostMost of this went undetected and unprosecuted, Mayes said, despite what she said were complaints registered by investigators for AHCCCS and within the office she inherited from Brnovich.Mayes estimated that in the past three years"hundreds of millions of dollars'' were lost due to fraud. But she declined to put a specific figure on it.

In 2019, she said, $53.5 million was billed to AHCCCS under the code of outpatient behavioral health services. That more than doubled to $132.6 million the following year, went to $291 million in 2021, and hit $668 million in the 2022 fiscal year.

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