AHCCCS fraud refers to intentionally deceiving Arizona’s Medicaid program (AHCCCS) to receive unauthorized benefits or payments. This can include billing for services not rendered, falsifying eligibility information, or submitting false claims.
AHCCCS fraud can be committed by medical providers, clinic owners, caregivers, or individuals receiving benefits. In any case, it involves knowingly submitting false claims, misrepresenting services, or providing inaccurate information to gain financial benefit from the state’s Medicaid program.
Common examples of AHCCCS fraud include:
When prosecuted, AHCCCS fraud charges are often accompanied by:
These charges are serious felonies that carry steep penalties and long-term consequences. At Feldman & Royle, we offer defense against criminal healthcare fraud charges with a focus on AHCCCS-related allegations.
Medical professionals, clinic operators, and health care businesses may face allegations for improper billing practices, misrepresenting credentials, or fabricating patient records. These investigations are often driven by statistical anomalies, whistleblower complaints, or audits.
Individuals may be accused of submitting false information during enrollment or continuing to receive benefits after their eligibility ends. Even small discrepancies can trigger an investigation that leads to criminal charges for Medicaid fraud.
AHCCCS fraud is not a simple administrative violation—it is a criminal offense under Arizona law. If convicted, penalties may include:
The Arizona Attorney General’s Office, often in coordination with the Office of Inspector General (OIG), aggressively pursues these cases. You need a team that knows how to push back.
Defending against AHCCCS fraud charges requires a strategic, well-informed approach that addresses both the legal and technical aspects of the case. At Feldman & Royle, we begin by protecting your rights from the outset, ensuring that you do not make any statements or decisions that could be used against you later. From there, we conduct a thorough review of billing records, eligibility documentation, and investigative procedures to identify weaknesses in the prosecution’s case. Whether the charges involve alleged overbilling, misrepresentation, or eligibility fraud, we challenge flawed audits, question the credibility of witnesses, and work with industry experts to present an accurate picture of what really occurred. Our goal is to secure the best possible outcome—whether that means reduced charges, dismissal, or a strong defense at trial.
If you’ve been charged with AHCCCS fraud or suspect you’re under investigation, you need a skilled Medicaid fraud defense attorney with deep experience in white collar crime and healthcare law. These cases require more than basic legal defense—they demand detailed analysis of billing records, financial data, and Medicaid policies.
At Feldman & Royle, we are known as trusted Phoenix Medicaid fraud attorneys who:
Whether you’re a provider, a caregiver, or an AHCCCS recipient, we deliver strategic and effective representation for healthcare and Medicaid fraud charges across Arizona.
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