Developmental Disabilities Fraud, Waste and Abuse
- Fraud is the intentional deception or misrepresentation that an individual knows, or should know, to be false, or does not believe to be true, and makes, knowing the deception could result in some unauthorized benefit to himself or some other person(s).
- Waste is the over-utilization of services that are not medically necessary or practices that result in unnecessary costs.
- Abuse describes provider practices that are inconsistent with sound fiscal, business or medical practices and result in unnecessary costs to Medicaid and Medicare.
Examples of Fraud, Waste and Abuse include:
- Providing or accepting kickbacks.
- Falsifying provider credentials
- Fraudulent enrollment practices.
- Double billing, upcoding
- Billing for services not provided.
- Substitution of services.
- Not accurately reporting financial resources during enrollment.
- Misrepresentation of medical conditions.
- Failure to report third party liability coverage.
Report Fraud, Waste or Abuse (FWA) to AHCCCS
Office of the Inspector General
- 602-417-4193
- Report Online at the AHCCCS Website
Report Provider Fraud
- In Arizona: 602-417-4045
- Toll Free Outside of Arizona Only: 1-888-487-6686
Report Member Fraud
- In Arizona: 602-417-4193
- Toll Free Outside of Arizona Only: 1-888-487-6686
Submit general questions via email at [email protected]
Report Fraud, Waste or Abuse (FWA) to DDD
Report by phone: 1-877-822-5799
Report by email: [email protected]
Send written reports to:
DES/DDD
Attn: Corporate Compliance Unit
1789 W. Jefferson Street
Mail Drop 2HA1
Phoenix, AZ 85007
Report online by completing the following form.