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Attendees speak out against AZ Medicaid fraud scheme targeting tribal members

Navajo leaders met Wednesday in Phoenix to address a massive scheme to defraud the state’s Medicaid system and that preyed on tribal members from as far away as Gallup, New Mexico.

Patients were taken to fake sober-living homes in the Phoenix area and, in some cases, allegedly held captive, while scammers billed the state’s Medicaid system, the Arizona Health Care Cost Containment System, or AHCCCS, for services that were never provided.

People lined up to speak during the meeting. But Shea Bella Wilson said many didn’t get a chance.

“Our delegates just walked out before they could get public input,” Wilson said. “And that's something that's very disappointing.”

Wilson said she feels officials should have been working to put more rehabilitation centers on Navajo Nation and a system to support them. And she criticized those who spoke to the public Wednesday night.

“Everyone just repeats themselves, repeats themselves, repeats themselves, saying they're concerned about the people,” she said. “It's bogus.”

Darius Stover works for Elite Innovative Health Services, an outpatient facility that focuses on care for Indigenous families. She says they’re receiving mixed messages from AHCCCS.

“We're told when they come to the audit that we did pass and then all of a sudden we didn't pass two days later,” Stover said.

According to Stover, some of the clients she sees have been struggling as a result.

“It's just a lot of uneasiness, especially in our clients, especially in this time where our funding has been shut down,” she said.

Stover said many on staff are volunteering to help clients stay sober. Dwightnette Mitchell with ICAN, another outpatient treatment clinic, said several of her employees are doing the same.

“They've had years and years of sobriety under their belt,” Stover said. “And now this is causing that to come back up.”

Denise Parker, who also works at Elite Innovative Health Services, said she continues going in.

“We’d rather volunteer our time than see these people have to try to go home,” Parker said.

According to Parker, “a lot of them really don’t have places to live.”

“I come from the reservation and I understand that more than half the people in our facility have nowhere to go,” Parker said. “Yeah, they say they’re going to take them home. But where is home?”

Kimberly Martinez also expressed concern about where victims will go once they are found.

“It sounded like a car salesman selling you what you want to hear,” Martinez said. “It's wonderful that they're talking about this, but what about the back end of it? You're going to be getting all these people back up north. What are you going to do when they relapse, when you don't have the treatment centers to help them?”

Stover expressed similar concerns about promised solutions, like temporary living facilities.

“With this forum that they had, I just personally feel like [they] didn’t give us enough time to express our concern,” Stover said. “We heard all their concerns and all these plans, but there’s no plans into action yet. Because everything’s on hold.”

Martinez and several people said they’re frustrated at what they see as a lack of communication and action.

“You know, where's the accountability of where our leaders have been? Because they're addressing the issue now, but it's like they've been doing this investigation for years,” Martinez said. “Why are our vulnerable still being taken?”

Officials encouraged scam victims to contact a 211 hotline.

Kirsten Dorman is a field correspondent at KJZZ. Born and raised in New Jersey, Dorman fell in love with audio storytelling as a freshman at the Walter Cronkite School of Journalism and Mass Communication in 2019.