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 |
