Self Disclosure Program for Providers
The OIG recognizes that many improper payments are discovered during the course of a provider’s internal review process. The Arizona OIG has developed a Self Disclosure approach to encourage and offer incentives for providers to investigate and report matters that involve possible fraud, waste, abuse or inappropriate payment of funds, whether intentional or unintentional, under the state’s Medicaid program.
THE AHCCCS’ LIST OF EXCLUDED PROVIDERS IS TEMPORARILY UNAVAILABLE.
If confirmation is required, please send your request to PRNotice@AZAHCCCS.gov
The request must include the following:
- Full legal name
- Social Security Number (last 4 digits is acceptable)
- Full date of birth (MM/DD/YYYY)
- Full legal name (include a ‘doing business as’, if applicable)
- Federal Tax Identification Number (TIN)
- National Provider Identification Number (NPI), if applicable
It is recommended that the request is sent in a secure email.