Head of AHCCCS details massive Medicaid fraud scandal
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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Пікірлер: 19
Maybe AHCCCS should have had better oversight to start with.
There are a lot of people that get Medicaid that are just lazy and fat. They are also on disability. It's a free ride for a lot of people. My cousin has a boyfriend and in his family they all grow up and start applying for disability because it's a family tradition. It's normal for them. Also my cousin decided one day that she had anxiety and couldn't leave the house not even for school. After applying several times she got approved and goes outside to spend her check. No anxiety then. Also drug addicts apply so they can stay home and get hi and still be able to pay the bills. I know a girl that deals drugs and doesn't work and she gets welfare housing and disability. What y'all need is an ordinary person to bust these people because we are the ones that see it.
👏👏👏 There has to be an END✝️🙏🏻 Keep up the good work and dismantle this mess. It just breaks my heart.😢 ❤️😀
@illudiumq36spacemodulator39
6 ай бұрын
Unfortunately nothing I hear in the news nowadays surprises me. Just another nail in the coffin of the human race. God's not going to stand for the sins of the human race much longer. When that day comes I don't know. Much longer could be now, tomorrow, next year or decades from now. I have been studying what's been going on in the world for the past 3 years. In my opinion never before has all the things happening now done so in so many numbers. War, rumors of war, disease, famine, greed, apathy, violence on a local scale everywhere, weather, no belief in God but belief in extraterrestrials, theft, perversion, and homosexuality. At just about any given time there are multiple shows about ET's on almost every pay channel. One of Satans accomplishments high on his list is convincing people he doesn't exist and with that God and Jesus don't exist. You can't believe in God and not Satan and get into heaven. It's all or none. Satan laughs and laughs at the human race especially every time someone dies in sin without accepting God into their heart. He knows there is no do over when the final resurrection happens and everyone is judged. I remember it wasn't that long ago that tv and movies on the 3 networks rarely had the actors and actresses take Gods name in vain. Now it happens all the time. Actresses and actors who wouldn't think of saying that a few years go now go with the flow for the money. They're afraid if they refuse to say it they will lose their job and will be labeled a troublemaker. They may have to get a non-acting job to pay the bills and they won't do that except as a last resort. I don't care how much money you make and how much money you have it can't buy you a place in heaven. There is no reason for writers to use Gods name in vain in the script or fu_k or any other profanity. They counter with, "but this is the real world language and we want to be realistic." No you want to use sensationalism to sell your product. Very sad.
We have a broken system in CA too. Independent living is where they are sticking people into homes that rent bedrooms to the programs for disabled, mentally ill etc... The city is passing the buck to the landlords to try to maintain these people. They are not being investigated for living conditions AT ALL. One Filipino woman converted her home into 10 bedrooms. Two twin beds in each room. She collects $1,100.00 per bed and feeds them crap. Lots of turn over in these places. Lots of theft and drug addiction being allowed.
@Melinda_Ross
6 ай бұрын
There is no money in regulating sober living, only letting it run amuck. Really shameful. There is the rich and powerful and then there is everyone else.
@tommas2674
6 ай бұрын
why Republicans like small gov.= example 87000 MORE IRS to not do their job but maybe look at their 3 + inch nails... smh, gov. agencies!, and medicals of any kind Every block is filled with medicals of some kind dentist to pc, to lol "mental health" But their prices don't come down only go up, and often on We the People tax payers, then obama care to allow them to at least triple dip, question: do "native" Americans on reservations pay taxes ? they I believe don't even have to adhere to civilized laws?
How do they did it 👍
And again the terrorists erased my comment!!!!!