'People in these homes were being recruited off the streets and being supplied with drugs just so that they could keep billing. Many people that I was there with did not survive,' said one woman during a state legislature hearing over the sober living scheme.
The sober living scheme that defrauded Arizona of an estimated $2.8 billion was under scrutiny at the Capitol on Wednesday, Sept. 30.It has been two years after a massive crackdown, and lawmakers are trying to hold the state’s Medicaid agency, the Arizona Health Care Cost Containment System , accountable.
Behavioral health providers say they’ve waited several months for AHCCCS to pay them for services provided. They believe that they’ve been scapegoated because of alleged bad actors who targeted vulnerable people, including tribal members, without providing real treatment.It was a packed house for the State Senate Health and Human Services Committee, with the focus on the multi-billion dollar AHCCCS scandal.There were clearly two sides to the issue: victims of fraudulent sober living homes, like a woman who says she was kicked out when she was eight months pregnant."People in these homes were being recruited off the streets and being supplied with drugs just so that they could keep billing. Many people that I was there with did not survive," said Casey Atkinson.Behavioral health providers claim to be wrongfully punished for the state’s 2023 crackdown that suspended hundreds of payments. Now, providers who have not been suspended are in fear of retaliation, while waiting for delayed reimbursements for services to patients under the American Indian Health Plan."We continue to accept these patients knowing full well it will likely result in uncompensated care, and we shoulder a heavy administrative burden as a result," said Heather Dukes, who represents behavioral health providers.Advocates for victims of the sober living scheme, meanwhile, say the fallout is far from over, as AHCCCS members have been moved to ACA marketplace plans so the billing can continue."They’re just being shuffled into these homes under the marketplace plans. You can see recruiters at the park actively recruiting," said Reva Stewart of Turtle Island Women Warriors.The committee’s chair, Republican State Sen. Carine Werner, questioned AHCCCS officials, including Inspector General Vanessa Templeman. There were several answers that could not be provided."Why hasn’t anyone from inside of our government in your department been held accountable for the massive fraud that has transpired?" State Sen. Werner asked."Madame chair, thank you very much for the question. I respect you. I respect every senator sitting on this panel today. I respect this branch of this government," Templeman responded. "While I would love to answer your question, I am unable to at this time, and I apologize for that. I understand that it is frustrating."New AHCCCS Director Virginia Rountree, who was recently nominated by Gov. Katie Hobbs, has not yet commented.
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