Arizona Health Care Cost Containment System often takes more than a year to initiate or complete an investigation, the state Auditor General's Office says.
By Howard Fischer Capitol Media Services PHOENIX — Arizona's healthcare program for low income clients is not doing a good job of investigating potential incidents of fraud or abuse committed by providers or patients, the state Auditor General's Office has concluded.
"Untimely fraud and abuse investigations could result in AHCCCS making unnecessary payments," she wrote in the report. And Perry said there clearly are such cases. And she said AHCCCS has not reviewed the health plans, with which it contracts to provide direct services to patients, once every three years as required. Perry said that goes to the question of whether the agency is making ``incentive" payments to providers for their performance without first determining that the providers actually are eligible.
Perry said that AHCCCS, as allowed by its process, did not assign it for investigation until October 2018.
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