Head of AHCCCS details massive Medicaid fraud scandal
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It’s been nearly a year
It’s been nearly a year since Carmen Heredia, cabinet executive officer, took over as the head of the agency, and she has spent the majority of that time trying to crack down on the fake rehab scheme targeting vulnerable people while bilking the state for nearly a billion dollars.
In a one-on-one interview with FOX 10 Investigator Justin Lum, Heredia talks about the changes being made to reign in the fraud.
In January 2023, Carmen Heredia had no choice but to face a scandal of massive Medicaid fraud as the new head of the Arizona Health Care Cost Containment System (AHCCCS).
"Focusing on something that was completely unexpected for me. It was new information walking into the job, and it's been our complete focus," Heredia said.
She’s talking about the scheme that preys on vulnerable people, including Native Americans fighting addiction.
Organizers of the scam entice victims to live in unlicensed and unregulated sober living homes, sign them up on the American Indian Health Plan and broker the "patients" to rehab centers so the services can be billed to AHCCCS.
The problem is that legitimate services aren’t provided.
The amount of money AHCCCS was billed for on one code alone skyrocketed from $53 million in 2020 to nearly $670 million in 2022.
Some providers billed for members who were minors, incarcerated or dead.
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9 ماه پیش
در تاریخ 1402/09/15 منتشر شده
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