OIG Statistics

The OIG Statistics page contains monthly figures that pertain to how fraud and abuse cases effect AHCCCS' bottom line. The following definitions explain some of the amounts displayed for the different areas of fraud and abuse.

Recoveries

The amount recovered from all cases for the month.

Program Savings

What AHCCCS actually saved for fraud/abuse recovery cases for the month.

Fraud Prevention Savings

The amount AHCCCS would have paid out if fraud/abuse was not detected.

Total Savings and Cost

Savings that were realized and costs that would have been spent had fraud/abuse not been detected.

January 2016

Member Compliance Unit
Recoveries (including Investigative Costs) $11,654.12
Program Savings: $79,449.84
Fraud Prevention Savings: $249,734.60
DES / OSI Savings $55,347.24
Number of Active Cases 597

Provider Compliance Unit
Recoveries (including Investigative Costs) $95,289.32
Program Savings $3,498.60
Number of Active Cases 562

Criminal Prosecutions
Number of Convictions - SFYTD 10
Number of Cases Accepted for Prosecution 82
Number of Cases Referred for Potential Prosecution 90

Global Settlements & Audits
Recoveries & Program Savings $624,006.07

Provider Registration
Enrollment Fees Collected $16,220.00
Number of Provider Site Visits 19

February 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $41,557.68
Program Savings: $52,417.32
Fraud Prevention Savings: $2,214,259.00
DES / OSI Savings $907,478.64
Number of Active Cases 583

Provider Compliance Unit
Recoveries (including Investigative Costs) $70,268.95
Program Savings $0.00
Number of Active Cases 318

Criminal Prosecutions
Number of Convictions - SFYTD 20
Number of Cases Accepted for Prosecution 60
Number of Cases Referred for Potential Prosecution 52

Global Settlements & Audits
Recoveries & Program Savings $178,810.88

Provider Registration
Enrollment Fees Collected $19,897.00
Number of Provider Site Visits 26

March 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $68,822.44
Program Savings: $44,470.42
Fraud Prevention Savings: $243,400.00
DES / OSI Savings $439,878.96
Number of Active Cases 534

Provider Compliance Unit
Recoveries (including Investigative Costs) $117,884.06
Program Savings $0.00
Number of Active Cases 330

Criminal Prosecutions
Number of Convictions - SFYTD 27
Number of Cases Accepted for Prosecution 61
Number of Cases Referred for Potential Prosecution 80

Global Settlements & Audits
Recoveries & Program Savings $49,622.98

Provider Registration
Enrollment Fees Collected $19,908.00
Number of Provider Site Visits 39

April 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $68,822.44
Program Savings: $54,473.02
Fraud Prevention Savings: $243,400.00
DES / OSI Savings $439,878.96
Number of Active Cases 530

Provider Compliance Unit
Recoveries (including Investigative Costs) $236,329.98
Program Savings $0.00
Number of Active Cases 331

Criminal Prosecutions
Number of Convictions - SFYTD 27
Number of Cases Accepted for Prosecution 61
Number of Cases Referred for Potential Prosecution 80

Global Settlements & Audits
Recoveries & Program Savings $49,622.98

Provider Registration
Enrollment Fees Collected $19,908.00
Number of Provider Site Visits 39

May 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $35,567.92
Program Savings: $131,119.62
Fraud Prevention Savings: $253,984.00
DES / OSI Savings $262,183.00
Number of Active Cases 556

Provider Compliance Unit
Recoveries (including Investigative Costs) $87,143.98
Program Savings $0.00
Number of Active Cases 405

Criminal Prosecutions
Number of Convictions - SFYTD 30
Number of Cases Accepted for Prosecution 68
Number of Cases Referred for Potential Prosecution 82

Global Settlements & Audits
Recoveries & Program Savings $11,611.25

Provider Registration
Enrollment Fees Collected $14,378.00
Number of Provider Site Visits 23

June 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $86,555.12
Program Savings: $76,473.24
Fraud Prevention Savings: $1,210,191.00
DES / OSI Savings $331,673.04
Number of Active Cases 618

Provider Compliance Unit
Recoveries (including Investigative Costs) $195,025.19
Program Savings $0.00
Number of Active Cases 425

Criminal Prosecutions
Number of Convictions - SFYTD 36
Number of Cases Accepted for Prosecution 72
Number of Cases Referred for Potential Prosecution 87

Global Settlements & Audits
Recoveries & Program Savings $111,694.10

Provider Registration
Enrollment Fees Collected $17,143.00
Number of Provider Site Visits 4

July 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $11,879.58
Program Savings: $126,838.36
Fraud Prevention Savings: $169,285.00
DES / OSI Savings $516,779.52
Number of Active Cases 525

Provider Compliance Unit
Recoveries (including Investigative Costs) $222,464.84
Program Savings $0.00
Number of Active Cases 486

Criminal Prosecutions
Number of Convictions - SFYTD 3
Number of Cases Accepted for Prosecution 75
Number of Cases Referred for Potential Prosecution 90

Global Settlements & Audits
Recoveries & Program Savings $150,933.27

Provider Registration
Enrollment Fees Collected $30,968.00
Number of Provider Site Visits 30

August 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $248,527.82
Program Savings: $133,408.76
Fraud Prevention Savings: $710,491.00
DES / OSI Savings $490,882.56
Number of Active Cases 512

Provider Compliance Unit
Recoveries (including Investigative Costs) $320,487.35
Program Savings $151,551.33
Number of Active Cases 499

Criminal Prosecutions
Number of Convictions - SFYTD 5
Number of Cases Accepted for Prosecution 79
Number of Cases Referred for Potential Prosecution 93

Global Settlements & Audits
Recoveries & Program Savings $403,451.15

Provider Registration
Enrollment Fees Collected $26,544.00
Number of Provider Site Visits 33

September 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $39,001.40
Program Savings: $145,200.96
Fraud Prevention Savings: $318,582.00
DES / OSI Savings $86,971.08
Number of Active Cases 548

Provider Compliance Unit
Recoveries (including Investigative Costs) $195,533.48
Program Savings $0.00
Number of Active Cases 534

Criminal Prosecutions
Number of Convictions - SFYTD 6
Number of Cases Accepted for Prosecution 77
Number of Cases Referred for Potential Prosecution 92

Global Settlements & Audits
Recoveries & Program Savings $20,335.95

Provider Registration
Enrollment Fees Collected $16,590.00
Number of Provider Site Visits 30

October 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $0.00
Program Savings: $233,717.76
Fraud Prevention Savings: $486,888.00
DES / OSI Savings $267,685.80
Number of Active Cases 522

Provider Compliance Unit
Recoveries (including Investigative Costs) $32,241.37
Program Savings $0.00
Number of Active Cases 563

Criminal Prosecutions
Number of Convictions - SFYTD 6
Number of Cases Accepted for Prosecution 86
Number of Cases Referred for Potential Prosecution 94

Global Settlements & Audits
Recoveries & Program Savings $375,084.90

Provider Registration
Enrollment Fees Collected $11,060.00
Number of Provider Site Visits 27

November 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $0.00
Program Savings: $145,415.52
Fraud Prevention Savings: $140,547.24
DES / OSI Savings $204,280.08
Number of Active Cases 589

Provider Compliance Unit
Recoveries (including Investigative Costs) $52,019.42
Program Savings $47,613.80
Number of Active Cases 570

Criminal Prosecutions
Number of Convictions - SFYTD 7
Number of Cases Accepted for Prosecution 85
Number of Cases Referred for Potential Prosecution 92

Global Settlements & Audits
Recoveries & Program Savings $479,896.00

Provider Registration
Enrollment Fees Collected $15,484.00
Number of Provider Site Visits 9

December 2015

Member Compliance Unit
Recoveries (including Investigative Costs) $39,941.66
Program Savings: $62,091.84
Fraud Prevention Savings: $408,919.36
DES / OSI Savings $99,738.72
Number of Active Cases 647

Provider Compliance Unit
Recoveries (including Investigative Costs) $2,361,075.31
Program Savings $0.00
Number of Active Cases 563

Criminal Prosecutions
Number of Convictions - SFYTD 10
Number of Cases Accepted for Prosecution 79
Number of Cases Referred for Potential Prosecution 90

Global Settlements & Audits
Recoveries & Program Savings $1,803.85

Provider Registration
Enrollment Fees Collected $17,969.00
Number of Provider Site Visits 6