MedicaidAdministrativeHigh impact
AHCCCS Suspends Payments to Behavioral Health Providers Based on Credible Allegations of Fraud
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
May 16, 2023
We identified it
Jun 17, 2026
Summary
AHCCCS has suspended payments to over 100 behavioral health providers based on credible allegations of fraud, particularly targeting providers serving tribal communities. The agency has implemented new high-risk categorization for three behavioral health provider types and enhanced monitoring systems to prevent fraudulent billing.
Action Required
Immediately: Billing teams working with AHCCCS/Medicaid behavioral health services must check the AHCCCS Office of Inspector General Provider Suspensions web page to verify all contracted behavioral health providers are not suspended. Update provider databases to flag any suspended providers. For suspended providers, continue submitting claims but expect payment delays pending investigation outcomes. Contact AHCCCS member hotline at 2-1-1 (press 7) for affected members needing alternative care arrangements.