You Can Help Stop Medicaid Fraud, Waste, and Abuse

The Office of Inspector General (OIG) investigates reports of suspected fraud, waste, and abuse of AHCCCS programs. Each year, OIG recovers and saves tens of millions of dollars in fraudulent claims from members and providers against Medicaid.

In SFY19, OIG recovered and saved more than $52.6M.

The primary way AHCCCS discovers fraud is through referrals from people like you. 

What does fraud look like?

Fraud is when someone lies or gives false information with the intent to receive benefits or payments for which they are not legally eligible. Members and Providers commit fraud in a variety of ways; here are just a few:  

Members

  • Provide incorrect household composition information
  • Falsify income or fail to report income 
  • Hide employment or self-employment information
  • Falsify Arizona or US residency status

Providers

  • Make false statements and false claims
  • Billing for services and supplies not provided
  • Double billing, over billing, and incorrect coding
  • Committing prescription and pharmacy fraud

If you suspect Medicaid fraud, don’t hesitate to report it. Anyone can anonymously report fraud, waste, or abuse. OIG depends on people like you–employees, members, providers and the general public to provide these referrals for investigation. 

To report possible Medicaid fraud, visit azahcccs.gov/ReportFraud

You may also submit attachments and/or additional information by email to AHCCCSFraud@azahcccs.gov.

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