AHCCCS has broad authority to exclude participating providers from its program. For example, AHCCCS may terminate a provider’s AHCCCS participation agreement if the provider fails to comply with their provider participation agreement, or with federal and state laws, rules, or regulations. AHCCCS must also suspend payments pending an investigation of a “credible allegation of fraud”…
On August 11, 2021, the U.S. Department of Justice (DOJ) issued a press release announcing a $350,000 settlement between the federal government, Cornell Scott Hill Health Corporation (“Cornell”), a Federally Qualified Health Center (“FQHC”), and the State of Connecticut to settle Medicaid fraud claims asserted against Cornell. As a FQHC, Medicaid pays Cornell for certain…
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