PHOENIX - The Arizona Health Care Cost Containment System (AHCCCS) Office of the Inspector General (OIG) accrued $291.4 million in savings and recoveries in State Fiscal Year (SFY) 2023, totaling more than the past five years combined, based on data recently released.
The Office of Inspector General opens, and closes, thousands of cases each year. These investigations are often extremely complicated and may take many months, or even years, to conclude.
In SFY 2023, OIG opened 8,869 cases, more than in any of the five prior years, and closed 8,039 cases. Since SFY 2018, a total of $537.2 million has been saved and recovered.
Hundreds of fraudulent member applications are investigated each year and denied before the applicant can access Medicaid benefits. In SFY 2023, 1,371 fraudulent applications were denied.
When a fraud investigation potentially involves criminal matters, OIG refers those cases to law enforcement partners like the Arizona Attorney General’s Office, the FBI, or the IRS, who then conduct a criminal investigation and/or prosecution. In SFY 2023, 38 cases referred to law enforcement resulted in criminal convictions.
Most Medicaid fraud investigations start with a referral from vigilant community members and stakeholders. Anyone can report fraud, waste, or abuse of the Medicaid program and may do so anonymously.
Report provider fraud by calling 602-417-4045 or 888-ITS-NOT-OK (888-487-6686). Report member fraud by calling 602-417-4193 or 888-ITS-NOT-OK (888-487-6686).
Submit a fraud tip to the AHCCCS Office of Inspector General using this Report Fraud form.
Learn more about the Office of Inspector General, savings and recoveries, and fraud investigations on the AHCCCS OIG web page.
