Bill > HCR2058

This resolution mandates a comprehensive audit of Arizona's Medicaid program, administered by the Arizona Health Care Cost Containment System (AHCCCS), to identify and recover improperly paid claims. The joint legislative budget committee director is required to hire a qualified audit vendor, defined as an entity with Medicaid audit experience and advanced technology, within 180 days to conduct a claim-level audit of all payments made in the three years prior to the audit, coordinating with the Centers for Medicare and Medicaid Services. This audit will categorize any "misappropriated claims," meaning improper payments like duplicate or incorrect charges, by provider type and managed care organization, while protecting sensitive information. Following the audit report, the joint legislative budget committee director and AHCCCS will have 90 days to negotiate settlements for these improper payments, with any unresolved matters referred to the Attorney General for potential lawsuits within 60 days. The costs of the audit will be covered by the recovered funds, and any remaining recovered money will go to the state's general fund. The director must then report the total amount of misappropriated claims and recovered funds to state leadership within nine months of the audit report. This section of the law will be repealed on December 31, 2030.

Government Affairs, Health and Social Services

https://apps.azleg.gov/BillStatus/BillOverview/85592