331 Research article EMHJ - Vol. Fee-for-Service Fee Schedules, Contact Us We remain committed to rooting out and prosecuting any individual who would use this crisis as an opportunity to defraud individuals or the government.. That, however, still left the issue of staff turnover and an insufficient number of investigators. The suspect must work for a Medicaid provider, such as a doctor, nursing home, hospital, adult care home, or home health agency. Get up-to-the-minute news sent straight to your device. The problems, the report says, are not limited to patients. Thanks to the diligent work of Arizonas COVID-19 Fraud Task Force, the FBI identified and dismantled fraud rings in Arizona which were trying to exploit the COVID-19 pandemic. Loabneh, and Lawabni own and operate A&N Services, LLC. About OIG - azahcccs.gov Audit: AHCCCS lagging in investigating abuse, fraud A complaint is simply the method by which a person is charged with criminal activity and raises no inference of guilt. A .gov website belongs to an official government organization in the United States. Examples include, but are not limited to: If you suspect that a vulnerable adult has been abused or neglected, report it immediately toAdult Protective Servicesat 1-877 SOS ADULT. Contact: (602) 417-4000, Phone: 602-417-4000 Perry said that AHCCCS, as allowed by its process, did not assign it for investigation until October 2018. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. A lot of people are gonna fall through the cracks, said Allen King, Sunrises chief administrative officer. Phoenix, AZ 85004, Phoenix: (602) 514-7500 The complaint alleges that Alsadi and the Dengas falsely billed AHCCCS for more than 1,500 non-emergency medical transports in April 2020 when those transports never occurred. Share sensitive information only on official, secure websites. If you suspect that Medicaid fraud has occurred, or abuse, neglect or exploitation has occurred in a Medicaid facility or by someone working for a Medicaid provider, immediately report the incident to the Medicaid Fraud Control Unit Monday - Friday 8:00-5:00pm at the Office of Attorney General: 2005 N Central Ave 21), Article 4, and in AHCCCS ACOM 446 (Grievance and Investigations Concerning Persons with Serious Mental Illness). In November 2020, AHCCCS upheld part of Contreras' grievance, noting that surveillance footage backed up his claim about being kept in restraints. PHOENIX Phoenix resident Curtis Nez credits outpatient treatment with helping him stay sober. The investigation developed allegations of multiple forms of fraudulent billing, including overbilling/double billing for services, billing for services that had not been rendered, and billing for AHCCCS members/patients who were deceased. United States Attorney's Office Announces Charges in Fraud Cases OIG Administrative Assistant, (602) 417-4193, General AHCCCS Information The investigation developed allegations that accuse the defendants of overbilling or double-billing for services, billing for services that had not been rendered, and billing for AHCCCS patients . AHCCCS said it was having difficulty in subpoenaing needed information from the member and the members employer because the member had moved and changed jobs multiple times since 2014. PDF AHCCCS PROGRAM INTEGRITY - STRATEGIC PLAN - azahcccs.gov endstream endobj startxref The FBI thanks the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), and the Arizona Health Care Cost Containment System Office of the Inspector General (AHCCCS-OIG) for their partnerships and collaboration on these cases. 3) Russell Freeman, 51 Richie.Taylor@azag.govMediaRequests@azag.gov, Attorney General Mark Brnovich Announces 13 Individuals and 14 Related Business Entities Indicted in Alleged Massive Health Care Fraud Billing Scheme, 49th Annual Peace Officers Memorial Service, Elder Abuse Information and Training Guide, Data Breach Notification Form Individuals, Lutheran Association of Missionaries and Pilots U.S., Inc. (d/b/a Lutheran Indian Ministries), Mary Group Home,a.k.a. Most of the estimated $21.4 billion cost is picked up by the federal government, with the $2.7 billion in state costs making it the largest item in the budget. Flagstaff: (928)556-0833 Doug Ducey to call a special legislative session to let lawmakers provide "additional clarity'' , For Star subscribers: A federal judge has blocked the state from enforcing a new law that he said could inadvertently make felons out of volun. Individuals are presumed innocent until proven guilty beyond a reasonable doubt. The FBI thanks the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), and the Arizona Health Care Cost Containment System Office of the Inspector General (AHCCCS-OIG) for their partnerships and collaboration on these cases. Tucson: (520) 620-7300 Residential rehab centers, which arent subject to the proposed cuts, worry about what will happen once they discharge their patients. All defendants are presumed innocent until proven guilty in a court of law. witness interviews, subject matter expert opinion analysis, and evidentiary review in order to determine preliminary findings. For example, at Sunrise Native Recovery their reimbursement has been $1,300 per patient per day. ) or https:// means youve safely connected to the .gov website. Mansour Ahmadi | Counter Extremism Project State v. Zeitner, 436 P.3d 484 | Casetext Search + Citator And while the agency said it is bringing new people on board, it said it can take a year to properly train them. New home buyers can sue over construction defects even if they signed waivers not to do so, the Arizona Supreme Court says in a new ruling. After the Arizona Governor and the President of the Navajo Nation both declared COVID-19 public emergencies, the need for non-emergency medical transports dramatically decreased. Main Office: Mansour Ahmadi is a U.S.-designated Iranian cyber hacker who, along with Ahmad Khatibi Aghda and Amir Hossein Nickaein Ravari, carried out a wide-ranging hacking campaign to compromise hundreds of computers across the United States and abroad. CycIA4[QMciX 9; Perry, however, said AHCCCS needs to do more. The charges include healthcare fraud, wire fraud, money laundering, and aggravated identity theft. grTkae`jK5]+wn_} Ox [hV2k1Y! @Uc$' x!Wmz I "|U;D&NL# Ce. We have successfully defended clients in parallel investigations and proceedings conducted by the Office of Inspector General (state and . Miguel Denga and Alsadi own and operate Philia Homecare, LLC. 362903). PDF AHCCCS Coordination of Benefits and Third Party Liability - azahcccs.gov The indictment also alleges the couple lied in their applications for COVID-19 pandemic-related loans and used the proceeds of the loan funds for personal expenses, such as the purchase of a residence in Mexico, where Zoila Henson is a citizen. PDF 446 GRIEVANCES AND INVESTIGATIONS CONCERNING PERSONS WITH - Arizona The OIG is designated as a criminal justice agency and is authorized by the Federal Bureau of Secure .gov websites use HTTPS But he said the solution is not to change the funding for all providers. The OIG also conducts unannounced site visits at certain providers' offices. One goes back to August 2014 with allegations that another adult was living in and contributing financially to the household. The unit is located in the Attorney General's Office, 2005 N Central Avenue in Phoenix. The proposal affects outpatient alcohol and drug treatment programs. Download the free version of Adobe Reader. Chandler Couple Arrested for AHCCCS Fraud and Pandemic Loan Fraud nr Cd86C3Y-LU'~WU0O3Z2P/O 58j!iPv@8:PEz/>#WVf?OK3J5Nw7QsnG:40'F7SRiM#4=( g]*3f$2TAAix91ix}d23B )nf:kFYR{3X\^&ZHhaS+ip *SWX*v RmSiZv6n*M7UXZlVtJxghJ@N'Gn/yrf_4 R7t|> 8I4"8^T~^v30,'!d9Py d90HH6_E\}Y+M`+'tew6 4 PDF Health-related quality of life of parents of children with That will just result in fewer services overall. 11) Sharon Lawson, 48 Subscribe to Newsletters 12) Thomas Battle III, 43 9) Trisha Wright, 38 She pointed out that in the last fiscal year, AHCCCS reported that it either recovered or saved about $48.1 million in state and federal funds. Tamarria Denga owns and operates COS 1, LLC. Yuma:(928) 314-6410. 4) Paul Flaa, 56 Official websites use .gov These same provisions also exhibit an intent to provide law enforcement access to . General Questions and Fraud Reporting Phoenix, AZ 85004, Phoenix: (602) 514-7500 R9-21-406. Policy. An Investigation of Factors Affecting the Teachers' Job Performance in Instead of reimbursing providers a percentage of their charges, they will get a flat rate per patient per day. Office of Special Investigations (OSI)/AHCCCS Office of Inspector hWmOF+T}t9zj!`)w=}Y` )Cew;;I{&CNOXDxI(hD3`6 hI3%R)ksB0 !HA1*` h>|?++^3vGW8]Ur9y4Uw Now more than ever, the integrity of our healthcare system is paramount as we fight a global pandemic, said United States Attorney Michael Bailey. The accused persons and businesseslisted beloware alleged to have fraudulently billed the states Medicaid agency, Arizona Health Care Cost Containment System (AHCCCS), for millions of dollars of services they claim to have provided to AHCCCS patients. Outpatient rehab in jeopardy for Native Americans under Medicaid proposal Title 9 Chapter 21, Article 4. That would drop to $157 per patient per day under the proposal.