Fraud of the Week

August 15, 2016

Health Insurance Fraud—Arizona

Amount: Unknown

An ongoing investigation is occurring due to allegations of widespread fraud, theft, and waste being uncovered in the group homes in Prescott Arizona. Many types of fraud were discovered. Sober living homes were charging up to $2,000 for routine drug urine tests. Clients were in sober living homes for up to fifteen months with no end in sight or being shuffled from home to home for unnecessary treatment. Homes were also making claims for “equine treatment,” costing as much as $5,000 for spending time with horses. The fraudulent activity caused spikes in insurance claims up to 500 percent in 2015. The investigation has sparked changes in the payment method causing over 100 group homes in Prescott to close their doors. There are concerns that causing these changes will result in negligent patient care in the remaining group homes. Investigators state that the reason the fraud was so outrageous was due to a lack of regulation of the industry.