Stop Fraud Before the Check Goes Out

Arizona’s sober-living fraud scandal is what the old government model looks like when it breaks. Vulnerable people, including Native Americans struggling with addiction, were promised treatment while bad actors billed Medicaid for care that often was not provided. FOX 10 reported that Arizona officials have now announced more than 140 indictments tied to the scheme, along with a 92% decline in fraudulent behavioral health billing on the American Indian Health Plan after enforcement began. Indictments matter. Recovering money matters. But the better question is why the checks went out in the first place. I raised this in my floor speech because the “pay and chase” model is from another century. Government pays the claim, finds the fraud later, hires auditors, hires lawyers, and then hopes taxpayers get some of the money back. Arizona saw roughly $2.8 billion in sober-living home fraud. I have been told a simple $1,500 accounting AI package could have flagged it almost immediately. That is where government has to change. Before Medicaid dollars leave the door, we should be using the data we already have to find billing patterns that do not make sense. Stop the bad claim before it becomes a bad check. Protect the taxpayer. Protect the people Medicaid is supposed to serve. Fraudsters should not get a head start just because government is too slow to look at the math. Back to News