[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6136753,"mediaKeyId","5609338-55fbce9ee89806ee4c383970bbcb4934","parentId",5609338,"title","Providers testify of payment delays, staffing cuts and alleged retaliation as fraud response continues","audioSeconds",367,"startMs",12268000,"endMs",12635000,"viewUrl","/Search/View?dp=1&key=5609338-55fbce9ee89806ee4c383970bbcb4934&start=12268&end=12635","thumbnailUrl","https://assets.pipeline.soar.com/5609338-55fbce9ee89806ee4c383970bbcb4934/thumbnail_12268000.jpg","articleUrl","/articles/6136753/Arizona/Providers-testify-of-payment-delays-staffing-cuts-and-alleged-retaliation-as-fraud-response-continues","mediaUrl","https://secure.pipeline.soar.com/6136753-af3c5735ba8aadbeb7c51d5c062b9108/orig.mp4?Expires=1770440103&Signature=iX9givC6fQXo8LjRcIU9uLhk6RnW5ykgV0ubI5hkRxONmLBycx1ogTAgc~HGzf6pFQIOl4ooIxl3oX4mtjVZ56A4Tx~ceYHNUdGjCBgSBANwWyq7N77kSSt0vvZjvXCc-4XWJtMjdLtP1GadTtbIhNKO5i8dFcMuLKV8KKEHN0Ib8SGol4RWfT26brk3gVEYZGU~dSn45fpwLCgpm7JxkIj8oyirEd6lNdpNru938ce14Bo~twEdJzWTu4xqIDbXZijTUAV-R9Tm7sjNs6EKqS-V60tr3RXLTeaIPM3Ej-pprWsDSFNxYOmY-V5lKcC2Cf0yt3rKRwOHxMZ6noueJA__&Key-Pair-Id=KUT5TJCACFTXG","author","Senate Health and Human Services","date","2025-08-18T00:00:00Z","article","Several providers and health‑care advocates told the Senate Health and Human Services Committee they have struggled with delayed payments, new billing rules and what some described as retaliatory actions by state agencies.

Representative statements and written submissions

Senator Angus and other committee members read testimony and constituent letters describing casework from providers the senators said had been forced to close or to scale back services after payments were withheld. One provider named in committee materials — identified in testimony as Arizona Integrated Telepsychiatry and Telemedicine Services LLC (AZITTS) — said in a written letter read to the committee that Access had withheld payments totaling more than $1,500,000 and that the provider's staff count and clinical operations were severely reduced. The letter charged that Access had \"diverted taxpayer funds to high priced attorneys\" while withholding payments to a provider that it alleged had been a whistleblower.

A separate account read into the record by Senator Angus described a nonprofit behavioral health provider that sought legislative help after being denied payment and then faced an unannounced DHS inspection. The senator said the provider was then told it was the subject of a possible referral to the Attorney General — a claim agency officials said in the hearing is part of an investigatory process for some cases and may relate to evidence developed in parallel criminal inquiries. The provider closure, the senator said, followed those actions; the provider has disputed criminal wrongdoing and has sought administrative remedies.

Attorney and provider testimony

Holly Giesel, a criminal defense attorney who handles health‑care and white‑collar matters, briefed the committee on historical patterns of fraud and urged use of compliance programs modeled on federal 26‑point compliance plans to help legitimate providers reduce risk. Doctor Laurie Henderson, CEO of a statewide nonprofit behavioral‑health organization, described how an '8‑minute' billing rule change reduced revenue for case‑management services and said the combination of payment delays and new billing rules has forced provider staff reductions and service cuts. Henderson presented a provider survey showing widespread impact: reduced budgets, fewer services and staff losses across many community providers.

What providers asked for

Providers and their representatives asked the committee to require clearer communication from Access, better provider assistance from the agency, and safeguards for providers that report suspected fraud. Several witnesses asked the committee to ensure the state provides technical assistance, clear rules and timely payments while criminal and administrative enforcement actions continue.

Ending

Committee members recorded the providers' concerns and asked Access, DHS and the AG's office to supply documents that could corroborate individual provider claims, including lists of suspended providers, timelines for payment processing, and copies of training materials and billing‑policy notices. Lawmakers said they planned follow‑up hearings to track progress and to evaluate whether current enforcement balances fraud prevention and access to care.","mediaType","Video","parentTitle","08/18/2025 - Senate Health and Human Services","oneSentenceSummary","Multiple provider representatives, an attorney and a nonprofit director told the committee that Access's fraud response and billing rule changes have left some providers unpaid, forced layoffs and closures, and, several witnesses alleged, prompted retaliatory behavior that discouraged providers from seeking legislative help.","taxTitle","Health and Human Services, Senate, Committees, Legislative, Arizona","taxId",15936,"location","Arizona","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6136758,"Arizona Department of Health Services explains licensing role and sober‑living rule changes",1181,9079000,10260000,"/Search/View?dp=1&key=5609338-55fbce9ee89806ee4c383970bbcb4934&start=9079&end=10260","https://assets.pipeline.soar.com/5609338-55fbce9ee89806ee4c383970bbcb4934/thumbnail_9079000.jpg","/articles/6136758/Arizona/Arizona-Department-of-Health-Services-explains-licensing-role-and-soberliving-rule-changes","https://secure.pipeline.soar.com/6136758-72b86110fb1d1eedffd440155da9f5d5/orig.mp4?Expires=1770440103&Signature=IzYAdMvVi4l-ncIgepmcWh1fqnXXQ3CQsbhdC7UMDIHS05fpx89f3URHlBzYuQH8Fxi6MjRxHwRvbZ2jJuAxn3VMNFxUWz0TnEyL39-aLWje6wENnMIUjlXfAphtT8mxq0eerj8ofKE4Ne-J0T2643ldc3j4sKCc-OQctYTG-C646xgyQGljxZgZoez0PuB4kndQSEqeMk5g1Z-CVSeQdfIE3fl7nQhBQgvJN5FmTBEBZmzLud41WG2NwAwfnXJIA23GaSBLMEAFbJgKfi7Iyvgy4AqvhbdcXr4YPyDB0rRYRzIANYN0WFIrRW~1Pq6IdT3EKa03EiwIwaZGJ31BOg__&Key-Pair-Id=KUT5TJCACFTXG","Tom Salo, assistant director for the Arizona Department of Health Services' Division of Licensing, briefed the Senate Health and Human Services Committee on how DHS licenses health care facilities, the department's inspection routines and recent statutory changes that affect sober living homes and behavioral health residential facilities.

\"Everything that we do is in statute,\" Salo told the committee, and he outlined the department's authority and limits. He said DHS has roughly 270 employees, manages several hundred licensed behavioral health facilities of different types, and recently moved many licensing functions into an electronic licensing system to speed applications and make records public through the department's AZCareCheck site.

Key points from DHS testimony

- Licensing and application workflow: Salo said his division now performs \"60–90 day touch points\" with new licensees to provide technical assistance early, conducts unannounced compliance inspections (annual for most HCIs unless deficiency‑free) and posts inspection histories and enforcement actions on AZCareCheck.

- Sober living and behavioral health residential definitions: Salo described statutory changes that expand the sober‑living definition and align enforcement tools more closely with other health care institutions. The new provisions increase civil monetary penalties in some cases, add fingerprinting requirements and make certain licensing records and enforcement visible to the department; he stressed that addresses for certified sober‑living homes remain confidential by statute.

- Complaint intake and prioritization: DHS explained its intake matrix used to triage complaints, with the highest priorities (immediate jeopardy) receiving the fastest on‑site responses. Salo said complaint volume has increased markedly in recent years and that DHS uses triage and priority protocols to assign resources.

What DHS does not do

Salo told the committee DHS' licensing role is limited to health and safety and that criminal investigations and Medicaid billing oversight are outside DHS' licensing authority. He said zoning, billing fraud and criminal prosecution fall to other agencies, though DHS will investigate complaints that fall within its statutory jurisdiction and pursue administrative enforcement when the evidence supports it.

Ending

Committee members requested copies of DHS' compliance officer training materials and additional documentation about complaint volumes, enforcement outcomes and the department's Tucson and Flagstaff staffing. DHS said it could provide the committee with the requested materials and noted that the department is updating rules and processes where statute permits.","ADHS described how licensing and inspections work, said it has increased electronic processing and implemented new touchpoints for new facilities, and noted statutory changes expanding the sober‑living definition and compliance tools.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6136763,"Attorney General: hundreds charged in Medicaid‑behavioral health investigations, large forfeitures recovered",400,10520000,10920000,"/Search/View?dp=1&key=5609338-55fbce9ee89806ee4c383970bbcb4934&start=10520&end=10920","https://assets.pipeline.soar.com/5609338-55fbce9ee89806ee4c383970bbcb4934/thumbnail_10520000.jpg","/articles/6136763/Arizona/Attorney-General-hundreds-charged-in-Medicaidbehavioral-health-investigations-large-forfeitures-recovered","https://secure.pipeline.soar.com/6136763-2a3205e7785ed37ac41880fe9fa2090b/orig.mp4?Expires=1770440103&Signature=Duj7ZutZmrWoAxZTiNdtR2atGmxSbnjijEYLqNm1z47N-IXggDnKayYAwaiRrCdgBdqnIlImTBiZxTOv90VQmgHZBkn9u8BAFbcP669SCtDLNrsLn8d5~QEW~ih9PG9AVVDeA5Yj0yMLwnrq1alsBf16FFJB5GeC-RTFhhBBhWEwdyCTWe4TUj3wZA1Q64uRoYhm8gu7uMmk4HDP-kFdvcmmn5cfxPRnyJH8irRx4Gl-1TEMSYQWpPCatwPCAR4ukWRLBizGetUFSmOTWX6TqMwuQDTwavq~d7~nU8df9B7qy7SHqnfcwWTtrT3d5CceLTxsyWM0FNjqh-hB5OetvQ__&Key-Pair-Id=KUT5TJCACFTXG","Nick Klingerman, head of the Attorney General's criminal division, told the Senate Health and Human Services Committee that the AG's Medicaid fraud unit has pursued a large national‑scale fraud network tied to behavioral health billing.

Klingerman said the office prosecutes criminal misconduct and works with federal partners and local law enforcement. \"We are the only statewide, prosecuting entity in Arizona,\" he said, describing the state unit's role as a Medicaid fraud control unit under federal arrangements.

What the AG described

Klingerman said the office has opened scores of criminal matters related to behavioral health billing and patient brokering. He told the committee his office had charged roughly 150–160 people in behavioral‑health‑related indictments, including corporations, and said about 56 matters had been resolved by sentencing or plea. He also said law enforcement has seized cash and assets and that forfeitures have returned funds to the state: \"We've seized over a $140,000,000 in cash,\" he said, and the office has forfeited roughly $100,000,000 to date.

Klingerman described a range of criminal conduct his investigators have documented: forged or nonexistent medical records, ghost billing (billing for patients who were not present), duplicative billing across providers, and patient brokering where recruiters received money in exchange for placing people in facilities. He described an undercover investigation that established a fictitious provider to demonstrate how brokers and facilities coordinated, and said his office has used search warrants, witness interviews and financial records to build criminal cases.

Patient brokering and outcomes

Klingerman highlighted patient brokering prosecutions and trials. He said one recent trial produced the first patient‑brokering conviction in state court under the statute noted during testimony and that the defendant received a prison sentence. He said his office has charged a large number of people for patient brokering across multiple investigations and is coordinating with federal partners and other states.

How the committee can help

Klingerman asked for continued support for staffing and investigative resources. He told the committee the unit recently received additional appropriations that are federally matched and said faster access to seized funds or adjustments to forfeiture processes would speed recovery for victims and taxpayers.

Ending

The AG's office characterized the investigations as resource intensive and dependent on witness testimony, financial forensics and interagency cooperation. Klingerman said the unit will continue investigations, prosecutions and forfeiture actions to recover public funds and hold fraud perpetrators accountable.","The Arizona Attorney General's Medicaid fraud unit told the committee it has opened and prosecuted numerous criminal cases linked to behavioral‑health billing schemes, seized substantial assets and obtained forfeitures to return funds to taxpayers.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6136768,"Arizona Medicaid agency and inspector general describe large-scale billing fraud tied to American Indian Health Program",794,1830000,2624000,"/Search/View?dp=1&key=5609338-55fbce9ee89806ee4c383970bbcb4934&start=1830&end=2624","https://assets.pipeline.soar.com/5609338-55fbce9ee89806ee4c383970bbcb4934/thumbnail_1830000.jpg","/articles/6136768/Arizona/Arizona-Medicaid-agency-and-inspector-general-describe-large-scale-billing-fraud-tied-to-American-Indian-Health-Program","https://secure.pipeline.soar.com/6136768-875239e62d6bf25035a20c438907af8f/orig.mp4?Expires=1770440103&Signature=Olq8IxrX3f~~3x4kxhtvtEKx-F7r5Lc8bsshubSi88olwtcZ1ZVh~V40bI9ALP-Zn7SHFhQ89Giuo1eAfcwbnMXQLpTOvrM88HY~UJVNbPJTRBUd3dH27XFtUTi9ByESleMidqdvBCe-BVv4jhx-UmUOx5CGy8hXiU2FmwIJpkQxpQznIQyCPMwJJo0iPiYFav89iF1v7ZqTBc~9Ha6U~QMwBkgxSJw4sWxzFkpkRgJafWOiB0CN9jOx07q45CAE-X26-om3IQorveIxTOpAP1ZOxdd9brOQwBHdTXnIjdh8WJqRGS90lgcjv6hU0-91pylttCVjTCB3I3LB4e-JUQ__&Key-Pair-Id=KUT5TJCACFTXG","Chairwoman Warner convened the Senate Health and Human Services Committee to hear testimony about a multi-year fraud scheme that Access Arizona officials say inflated spending in the American Indian Health Program, disrupted care and exposed gaps in oversight.

\"The fraud we have seen ripped through the behavior health landscape is staggering,\" Marcus Johnson, deputy director of Access, said in his opening remarks. Johnson told the committee that Access identified a steep increase in fee‑for‑service payments to the American Indian Health Program between April 2020 and roughly March 2023 — rising from the tens of millions of dollars to the hundreds of millions of dollars in the period shown on the agency's charts.

Why it matters: committee members were told the scheme carried two kinds of harms — large taxpayer losses and direct harm to members. Witnesses described people being recruited into unlicensed or unsafe facilities, denied choice and basic needs, and in some cases moved across state lines.

How the scheme worked and how Access responded

Access staff and the agency's inspector general said bad actors used recruitment, patient brokering and false enrollments to shift people into the American Indian Health Program and to bill Medicare/Medicaid for services that were never provided. Marcus Johnson said the agency saw an increase in paper check payments and in members switching from managed care into the American Indian Health Program during the period of concern. He told the committee the agency found both non‑Native individuals enrolled improperly and large per‑member payments that far exceeded prior norms.

Vanessa Templeman, inspector general, described site visits and investigations that found people living in squalid or controlled conditions, denied choice of provider and, in some locations, locked in rooms. \"We've seen patients denied their patient choice and their right to choose what provider they want to see,\" Templeman said, and added investigators found \"billing for services that members were never even there\" and \"billing for excessive hours, more hours than can exist within a 24 hour period.\"

Access described a multi‑pronged response: hundreds of \"credible allegation of fraud\" (CAF) payment suspensions, a temporary provider‑enrollment moratorium for several provider types, tighter verification for the American Indian Health Program, additional documentation and prepayment reviews for outlier claims, and new data‑analysis systems to identify patterns.

Johnson summarized humanitarian and remediation steps the agency took while investigations were underway: temporary lodging and counseling for people the agency identified as victims, a dedicated hotline that the agency said fielded tens of thousands of calls, and transport for a number of individuals back to their home states. He also said Access commissioned an external audit and adjusted reimbursement and coding rules to reduce the opportunity for abuse.

Numbers presented to the committee

Access presented trend charts showing a rise in fee‑for‑service payments to AIHP between 2020 and 2023 and large swings in per‑member payments. Johnson and Templeman gave the committee a set of enforcement and outcome totals: the agency reported hundreds of CAF suspensions since mid‑2023, dozens of state fair hearings, and more than 100 rescinded suspensions after appeals or additional documentation. On the Office of Inspector General's cost‑avoidance slide, Johnson showed year‑by‑year figures the OIG identifies as cost avoidance and recovery: the presentation named roughly $32 million for fiscal year 2022, about $272 million for a later year, and a figure near $945 million in the most recent year shown. Committee staff requested documentation for all of those numbers during questioning.

What's next

Committee members pressed Access for further documents and for specific staffing and timing information. Several lawmakers asked for detailed provider lists, staffing charts and the accounting trail for large payments that have been reported in the media. Access officials said some details are the subject of ongoing litigation and that other specific financial breakdowns would be provided to the committee after follow up.

Ending

The committee left the session with follow‑up requests for documentation about all elements of Access's response, including provider suspension counts and timelines, details of the AIHP verification process, and the agency's plans for the new pre‑ and post‑payment review system planned for 2026.","Access Arizona and its inspector general told the Senate Health and Human Services Committee that a broad, multi-year fraud scheme inflated American Indian Health Program payments, trafficked and displaced vulnerable people and prompted hundreds of provider payment suspensions and policy changes by the agency.","actionData","errors"]

Article not found

Providers testify of payment delays, staffing cuts and alleged retaliation as fraud response continues

Arizona Department of Health Services explains licensing role and sober‑living rule changes

Attorney General: hundreds charged in Medicaid‑behavioral health investigations, large forfeitures recovered

Arizona Medicaid agency and inspector general describe large-scale billing fraud tied to American Indian Health Program