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Providers say unpaid claims and alleged retaliation followed fraud crackdowns
Summary
Multiple providers and lawmakers told the committee that legitimate behavioral-health providers, particularly those serving Native American communities, experienced long payment delays, denials with shifting explanations, and actions they described as retaliatory after seeking help from Access.
Several providers and constituent statements read into the record described severe business and patient-care consequences they attribute to Access's post-fraud enforcement and claims-processing changes.
Senator Angus recounted constituent complaints about a Phoenix provider (referred to in testimony as "ACME") that said Access stopped paying tens of millions in claims and then gave shifting reasons for denials during training and vendor calls. "At the end of the meeting, Acme was told that all of their claims more than 800 were missing a required signature and would have to be resubmitted again," Angus said while summarizing the provider's account; she said the provider believed it was being targeted for seeking legislative help.
A separate written statement from Arizona Integrated Telepsychiatry and Telemedicine Services (AZITTS) was read for the record. The letter said the company reported fraud in 2019, had its Mesa office raided and equipment seized, and later experienced systematic withholding of payments with more than $1.5 million of claims unpaid; the letter said the agency never alleged the claims were fraudulent but nevertheless refused payment.
Witnesses and lawmakers described operational effects: providers closing sites, layoffs, reduced services and difficulty serving rural and tribal communities. Jewish Family & Children's Service and other provider representatives reported program closures after a roughly eight-month moratorium and the implementation of an "8-minute" billing rule that, they said, reduced reimbursable units and revenue; one provider survey cited in testimony reported 82% of respondents had reduced budgets and 60% reduced services.
Access and the OIG acknowledged provider hardship in testimony but said due-process protections exist, including informal settlement conferences and state fair hearings; OIG leaders said they frequently meet with providers and have rescinded suspensions when documentation supports reactivation. Access officials committed to produce requested documentation and to work with stakeholders to smooth technical assistance and training.
The committee requested documents and contact information for Access budget leads and asked that agencies provide detailed lists of denied/pended claims and timelines for remittance. No formal action was taken at the hearing; members signaled intent to reconvene once agencies deliver promised data.
