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Mercy Care received the following important communication that we wanted to pass along to our provider network.
AHCCCS is aware of individuals targeting American Indians/Alaskan Natives who reside on tribal reservations by recruiting and transporting them to live in what they are calling sober living homes or behavioral health residential facilities in Phoenix. Some are not licensed health care providers who are not following through with promised services.
We encourage AHCCCS members to be extremely cautious about getting into vehicles with individuals they do not know, and to advocate for your own health care services before accepting treatment. Ask questions and obtain as many details as possible, including the company name and address, name of individual, facility address, whether the facility is licensed, vehicle license plate number (if applicable), and date and location of contact.
Learn more from media coverage in the Arizona Republic and Indian Country Today, and from this Facebook post from the Navajo Police Department. Some reports indicate possible criminal activity. If you have knowledge that someone has been targeted, please contact local law enforcement or Phoenix FBI at 623-466-1999.
AHCCCS is working with its stakeholders to ensure that the agency is using its full regulatory authority to identify and terminate involved providers (however, some are not AHCCCS registered providers), and to ensure member safety. Since January 2022, AHCCCS has terminated 270 enrolled providers for various reasons, including exclusions, reported facility closures, findings of fraud, validated quality of care matters identified during Quality Management onsite reviews, and other matters related to the integrity of the Medicaid program. AHCCCS is also referring any potential criminal activity to the Arizona Attorney General’s Office and working with law enforcement as needed.
Report Fraud
AHCCCS actively investigates all reports of fraud, waste, and abuse against the Medicaid program. Anyone can report provider or member fraud on the Report Fraud web page or by calling:
Report Provider Fraud
In Arizona: 602-417-4045
Toll Free Outside of Arizona Only: 888-ITS-NOT-OK or 888-487-6686
Report Member Fraud
In Arizona: 602-417-4193
Toll Free Outside of Arizona Only: 888-ITS-NOT-OK or 888-487-6686
AHCCCS Members Have Rights
If you are approached by someone offering housing assistance, know your rights. You have the right to know whether the provider is licensed, what services they will provide, and how they will ensure your care. Ask questions before agreeing to health care services. You have the right to coordinate care through your tribal case manager, if applicable.
Report Concerns About the Quality of Care Received
AHCCCS is committed to ensuring that all members receive quality health care and are able to access services. If you or any AHCCCS member has experienced a barrier to getting health care services or have concerns about the quality of services received, please report it to Clinical Quality Management (CQM) using this online form, by calling (602) 417-4885, or by emailing CQM@azahcccs.gov. All submissions are confidential and protected by Arizona State statute.
Sincerely,
Christine Holden
AHCCCS Tribal Liaison
As always, don't hesitate to contact your Mercy Care Network Management Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website.
Thanks for all you do!
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