[{"_1":2,"_100":-5,"_101":-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],{"_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",6447190,"mediaKeyId","5872835-7820704935ef8ce9411e6a9cb74296b2","parentId",5872835,"title","Senate committee hears accounts of patient brokering and widespread Medicaid behavioral-health fraud targeting Native Americans","audioSeconds",13850,"startMs",531000,"endMs",14381000,"viewUrl","/Search/View?dp=1&key=5872835-7820704935ef8ce9411e6a9cb74296b2&start=531&end=14381","thumbnailUrl","https://assets.pipeline.soar.com/5872835-7820704935ef8ce9411e6a9cb74296b2/thumbnail_531000.jpg","articleUrl","/articles/6447190/Arizona/Senate-committee-hears-accounts-of-patient-brokering-and-widespread-Medicaid-behavioral-health-fraud-targeting-Native-Americans","mediaUrl","https://secure.pipeline.soar.com/6447190-a0bcdc951912d2731b3b921a2ca87365/orig.mp4?Expires=1770595301&Signature=FxGi7KMdzQ6N11DL0hmSqMf50z0qk~YMeN1eARKsP1m4xfTAUuQV-89rcpnBY18F-Lqd3-M4VDe0gRlcILTTLX-Y798nyhf4OvEJp9YoU144MPpvezp2g7BSekACY5QfJLLWy0MDF~7laKz6R2BMnHUBKRMhwMOUJXruHyJzQc1tjmJVyyqFGP7tVrBK9an62EY7uavfvMCJhqarErAFz1LHzkvib3D~VNvXLNz93e6w3L-MPhVqBDjK1RQQYn31GRVzhBUIa97nP4UG0zJfmtLMmxqN0dQ8fzrf~ix6ltzdQGIFOQKrRnFRuYIEGkni4TI77AcbpLV4dj5X6oQPEw__&Key-Pair-Id=KUT5TJCACFTXG","author","Arizona Legislature","date","2025-10-01T00:00:00Z","article","PHOENIX — The Arizona Senate Health and Human Services Committee spent hours hearing testimony about organized fraud, patient brokering and the collapse of oversight in the state's behavioral-health system, with witnesses saying Native American people were disproportionately targeted and providers and patients continue to suffer.

Advocates and tribal leaders described schemes in which recruiters steered people into unlicensed or predatory sober-living homes and treatment programs that billed Medicaid or steered members into commercial marketplace plans. Committee members and witnesses cited a range of figures for the fiscal impact; testimony at the hearing referenced an estimated $2.8 billion in fraud and roughly 140,000 disenrolled Access recipients.

The hearing featured multiple survivors and grassroots groups describing the human toll. Rita Stewart of Turtle Island Women Warriors told the committee her organization has compiled thousands of complaints and humanitarian responses and said she stopped filing reports with the federal Office of Inspector General because she believes reports were being leaked back to facilities and traffickers. \"We cannot continue to put our volunteers and survivors at risk by feeding information back to the traffickers,\" Stewart said.

Vanessa Templeman, inspector general for the state's Access program, acknowledged that her office must comply with legal processes that can require disclosure and said anonymous reports remain possible. \"To the extent my Office of Inspector General is able to keep items confidential, we do,\" Templeman said, while also noting subpoenas, court orders and referrals to law enforcement can require disclosure. When pressed on whether reports had been turned over to subjects of investigations, she said she could not provide counts on the floor but offered to take the question away and report back.

Providers and provider groups described a second set of problems: overcorrection by Access and a reformed claims and prior-authorization system that, they say, has left legitimate providers without timely payment. Amy Graves, CEO of The Haven in Tucson, told the committee her nonprofit remains accredited and licensed but is owed about $375,000 for services billed under the American Indian Health Program. \"Every day that funding is withheld from legitimate providers like the Haven, more people lose access to life-saving treatment,\" Graves said.

Access and fee-for-service officials defended the changes as necessary to stop criminal operations and described steps to identify suspicious billing, to increase prepayment review and to coordinate with law enforcement. Lynn Emmons, assistant deputy director for fee-for-service programs, said the approval rate for behavioral-health claims subject to prepayment review has risen to about 84 percent, and she described two categories used to flag claims for review: providers whose coding is two standard deviations above peers and providers with other identified concerns. Emmons said 382 providers were added to a 100 percent prepayment review list in January'February 2024, most of them in that early period of heightened scrutiny.

Committee members repeatedly pressed Access officials for more transparency and faster remedies for providers they described as \"good actors\" caught in enforcement measures. Chair Sen. Michelle Warner closed the hearing by demanding a list of deliverables from Access within 30 days and scheduling another committee meeting in about 45 days to review progress.

Why it matters: Witness accounts tied the fiscal impact and the systemic failures to lost lives, trauma and fractured tribal trust. Several advocates testified to missing and deceased relatives they believe were trafficked into treatment networks. Tribal leaders and providers told the committee the effects go beyond dollars: families remain separated, some people remain missing, and community providers are struggling to survive financially.

What's next: The committee requested specific data and timelines from Access and the inspector general, including provider counts, audit outcomes and the status of referrals to prosecutors. Members said they will reconvene to evaluate Access's promised deliverables and to press for both enforcement of criminal activity and protections for legitimate providers and patients.

Provenance: The article is based on testimony and exchanges recorded during the Arizona Senate Health and Human Services Committee hearing, including public-comment testimony by Rita Stewart (Turtle Island Women Warriors), Amy Graves (The Haven), and statements from Office of Inspector General head Vanessa Templeman and Access fee-for-service leadership.","mediaType","Video","parentTitle","10/01/2025 - Senate Health and Human Services","oneSentenceSummary","The Arizona Senate Health and Human Services Committee heard testimony that organized schemes trafficked Medicaid members into fraudulent sober-living and treatment operations, causing large estimated losses and a disproportionate impact on Native American people.","taxTitle","2025 Legislature Arizona, Arizona","taxId",78572,"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},6447181,"Advocates tell senators death of Arizona man underscores gaps in SMI residential treatment and court oversight",109,75000,184000,"/Search/View?dp=1&key=5872835-7820704935ef8ce9411e6a9cb74296b2&start=75&end=184","https://assets.pipeline.soar.com/5872835-7820704935ef8ce9411e6a9cb74296b2/thumbnail_75000.jpg","/articles/6447181/Arizona/Advocates-tell-senators-death-of-Arizona-man-underscores-gaps-in-SMI-residential-treatment-and-court-oversight","https://secure.pipeline.soar.com/6447181-5c4b1c92b2fcff5ec2ecc7cdead84e80/orig.mp4?Expires=1770595301&Signature=dI2~JdAp3i3jUpg5aJKG1QRLmFuP7JLKdFxuUkkjG-Uil5RNK5woz9sy5v4DqWJLCRyGOBbDhZqWZcZ0hj3ZjAJrF3OWDRSQGaOTkjTAbxAp99VBmBX18R7sBYLg6LeBOZgsaWF5pJlgKbRaCbCS8MTxz-6SA6G3H3UZIxU9EJLhyFCopXNCKfd2GKeGf1qDtLoONnyIxE0Fd5Omx4qRzp94gznEygfMi5A5tJfWRbovil-16MJAfoZAQv0uCgc7bqy5ibVjfvP~38fGHyZHjbImK8VcWlN5jPmimIJiJ8OsaV9K~KLHLgdr~Z1kaOmN6-vIatjgur4Q6bvzOBwLAg__&Key-Pair-Id=KUT5TJCACFTXG","PHOENIX — Family members and mental-health advocates opened an Arizona Senate Health and Human Services Committee hearing with testimony about the death of Larry Bootsma, a man with schizophrenia and a traumatic brain injury, whose parents and advocates said he died after repeated system failures.

Rachel Stryfe, speaking on behalf of Helen and Elverne Bootsma and as co-founder of Arizona Mad Moms, said Larry was found dead at a Phoenix bus stop hours after visiting his clinic. Stryfe told the committee that Larry had an Assertive Community Treatment (ACT) team and a public fiduciary guardian but still cycled through hospitals, lived outdoors and lacked secure residential care.

\"No measurement of outcomes, no real care. This is waste, fraud, abuse, and neglect in real time,\" Stryfe said, attributing part of the problem to what she described as the legislature's failure to fully fund secure residential treatment. Stryfe and other witnesses cited a sequence of budget reductions: testimony said a proposed $25 million appropriation was reduced to $5 million and later to $3.5 million after internal reallocation; witnesses presented those figures as the reason secure treatment capacity remained insufficient.

Witnesses also raised long-term changes in hospital capacity, noting that the state closed a large share of hospital beds since the Arnold v. Sarn litigation and that supported-housing units promised by that settlement had not kept pace with population growth. \"In Arizona, SMI are 32 times more likely to be jailed than hospitalized,\" Stryfe said at the hearing.

Senators and witnesses described both short-term and structural remedies: increased funding for court-ordered evaluation beds and residential treatment, better court oversight of ACT teams, and stronger support for public fiduciary offices. Chairwoman Michelle Warner framed the committee's responsibility as ensuring access to care and protecting taxpayer dollars.

Why it matters: Witnesses placed Bootsma's death in the context of systemic underinvestment in serious mental illness (SMI) services and gaps in accountability for treatment outcomes. The testimony linked budget choices and policy decisions to immediate patient harm.

What's next: The Bootsma testimony was part of a larger hearing on behavioral-health fraud and oversight; committee members directed continued investigation and oversight. The hearing record includes calls for concrete funding and policy changes to expand secure-treatment capacity and improve court and guardianship oversight.

Provenance: Testimony by Rachel Stryfe (Arizona Mad Moms) and introductory remarks by Chair Michelle Warner.","Family members and the group Arizona Mad Moms said Larry Bootsma, who had serious mental illness, died after repeatedly cycling through hospitals and living on the streets despite an ACT team and a court-appointed guardian; witnesses blamed underfunding of secure residential treatment and urged legislative action.",{"_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},6447186,"Providers say Access's post-fraud controls left behavioral health facilities unpaid; agency cites prepayment reviews and staffing limits",1369,6661000,8030000,"/Search/View?dp=1&key=5872835-7820704935ef8ce9411e6a9cb74296b2&start=6661&end=8030","https://assets.pipeline.soar.com/5872835-7820704935ef8ce9411e6a9cb74296b2/thumbnail_6661000.jpg","/articles/6447186/Arizona/Providers-say-Accesss-post-fraud-controls-left-behavioral-health-facilities-unpaid-agency-cites-prepayment-reviews-and-staffing-limits","https://secure.pipeline.soar.com/6447186-180da43e6055e8552d2ac940f3cb8844/orig.mp4?Expires=1770595301&Signature=AmmyZCHs5fQpCiPhcwYYQVt71rod-wD9s6F46amQLhVtzgEGUQGZxUDz71TaJO1y4qSdLs8zHFIylndOtpR-kqUHjYUhRcWTbsbeNZaFUuCXbAJBqmHjITWw~HUojEXEGCQLkZJd16quX2YYmu6CNQkyxrnh5GJ5mvy59KchTsay7vs835z7XvVIrlYAu25NmYk~1VXb~LwK8XbeqOd4ue20Fwzi09Jw-ssNaA8NQ5yODDQeWg3KizYn5~sZDdi1afEyfuvkXfmnpU~8DgPwvTL5vdcGv4Btuw7s5EzvNfjbNsoCqCjW6lHS8XKZl14MBKyaoxCJMs9~7OnHVH37DA__&Key-Pair-Id=KUT5TJCACFTXG","PHOENIX — Dozens of behavioral-health providers and trade groups told the Arizona Senate Health and Human Services Committee that reforms intended to stop criminal patient-brokering have had unintended consequences: longstanding, licensed providers report months-long payment delays, unpredictable prior-authorization processes and financial strain.

Representatives of the Arizona Council of Human Service Providers and nationally accredited behavioral-health operators described prolonged payment waits and prior-authorization backlogs that in some cases forced programs to carry costs for weeks or months. \"These prolonged payment delays on top of inadequate rates make it increasingly difficult for providers to keep their doors open,\" Michelle Coldwell of the Arizona Council of Human Service Providers said.

Several witnesses testified that the American Indian Health Program (AIHP) population has been particularly affected. Amy Graves, CEO of The Haven in Tucson, said the nonprofit accepts AIHP members but is currently owed about $375,000 for AIHP-billed services. \"The Haven has never been investigated or accused of any fraud, waste, or abuse and is stuck in a situation that is not of its own making,\" Graves said.

Access fee-for-service officials explained how claims and prior-authorizations are reviewed under new safeguards. Lynn Emmons, assistant deputy director for fee-for-service programs, said prepayment review flags fall into two categories: providers whose coding is two standard deviations above the peer average (automatic \"spike\" flags) and a provider-based group flagged for full review where prior concerns exist. Emmons told the committee that about 382 providers were added to a 100 percent prepayment-review list in January'February 2024, and that the approval rate of behavioral-health claims that reach the prepayment-review process has risen to roughly 84 percent.

On timing, Access officials acknowledged long turnarounds for some processes. Emmons said clean claims are adjudicated within about 10 days, while claims placed on prepayment review average about 131 days. She said prior-authorization turnaround for non-urgent requests is averaging around 17 days (urgent reviews are handled in 72 hours). Committee members and providers said those timeframes are inconsistent with clinical needs: providers said patients often complete treatment before authorizations are returned and providers end up bearing the cost.

Providers and advocates requested concrete remediation: a provider-relations contact, faster appeals and clearer, timely technical assistance. Access leaders acknowledged gaps and said they are adding staff, building provider-relationship teams and developing dashboards to show turnaround times and case status.

Why it matters: Behavioral-health providers operate on narrow margins and require timely reimbursement to remain solvent. Multiple witnesses reported closures, layoffs or significant write-offs linked to prolonged payment delays and marketplace-plan switching tied to the fraud schemes.

What's next: The committee requested additional data from Access, including provider counts, suspension and termination numbers, appeals and rescissions dating back to 2019, and promised a follow-up hearing to review the agency's plans.

Provenance: Reporting from testimony by Michael Coldwell (Arizona Council of Human Service Providers), Heather Dukes (accredited providers), Amy Graves (The Haven) and Lynn Emmons (Access DFSM).","Licensed providers and trade groups told a Senate committee that changes after the fraud crackdown have delayed payments, paused enrollments and threatened operations; Access officials said prepayment reviews and prior-auth changes were necessary and cited staffing, retention and technical-assistance steps.","actionData","errors"]

Article not found

Senate committee hears accounts of patient brokering and widespread Medicaid behavioral-health fraud targeting Native Americans

Advocates tell senators death of Arizona man underscores gaps in SMI residential treatment and court oversight

Providers say Access's post-fraud controls left behavioral health facilities unpaid; agency cites prepayment reviews and staffing limits