PHOENIX — The Arizona Senate Health and Human Services Committee spent hours hearing testimony about organized fraud, patient brokering and the collapse of oversight in the state's behavioral-health system, with witnesses saying Native American people were disproportionately targeted and providers and patients continue to suffer.

Advocates and tribal leaders described schemes in which recruiters steered people into unlicensed or predatory sober-living homes and treatment programs that billed Medicaid or steered members into commercial marketplace plans. Committee members and witnesses cited a range of figures for the fiscal impact; testimony at the hearing referenced an estimated $2.8 billion in fraud and roughly 140,000 disenrolled Access recipients.

The hearing featured multiple survivors and grassroots groups describing the human toll. Rita Stewart of Turtle Island Women Warriors told the committee her organization has compiled thousands of complaints and humanitarian responses and said she stopped filing reports with the federal Office of Inspector General because she believes reports were being leaked back to facilities and traffickers. "We cannot continue to put our volunteers and survivors at risk by feeding information back to the traffickers," Stewart said.

Vanessa Templeman, inspector general for the state's Access program, acknowledged that her office must comply with legal processes that can require disclosure and said anonymous reports remain possible. "To the extent my Office of Inspector General is able to keep items confidential, we do," Templeman said, while also noting subpoenas, court orders and referrals to law enforcement can require disclosure. When pressed on whether reports had been turned over to subjects of investigations, she said she could not provide counts on the floor but offered to take the question away and report back.

Providers and provider groups described a second set of problems: overcorrection by Access and a reformed claims and prior-authorization system that, they say, has left legitimate providers without timely payment. Amy Graves, CEO of The Haven in Tucson, told the committee her nonprofit remains accredited and licensed but is owed about $375,000 for services billed under the American Indian Health Program. "Every day that funding is withheld from legitimate providers like the Haven, more people lose access to life-saving treatment," Graves said.

Access and fee-for-service officials defended the changes as necessary to stop criminal operations and described steps to identify suspicious billing, to increase prepayment review and to coordinate with law enforcement. Lynn Emmons, assistant deputy director for fee-for-service programs, said the approval rate for behavioral-health claims subject to prepayment review has risen to about 84 percent, and she described two categories used to flag claims for review: providers whose coding is two standard deviations above peers and providers with other identified concerns. Emmons said 382 providers were added to a 100 percent prepayment review list in January'February 2024, most of them in that early period of heightened scrutiny.

Committee members repeatedly pressed Access officials for more transparency and faster remedies for providers they described as "good actors" caught in enforcement measures. Chair Sen. Michelle Warner closed the hearing by demanding a list of deliverables from Access within 30 days and scheduling another committee meeting in about 45 days to review progress.

Why it matters: Witness accounts tied the fiscal impact and the systemic failures to lost lives, trauma and fractured tribal trust. Several advocates testified to missing and deceased relatives they believe were trafficked into treatment networks. Tribal leaders and providers told the committee the effects go beyond dollars: families remain separated, some people remain missing, and community providers are struggling to survive financially.

What's next: The committee requested specific data and timelines from Access and the inspector general, including provider counts, audit outcomes and the status of referrals to prosecutors. Members said they will reconvene to evaluate Access's promised deliverables and to press for both enforcement of criminal activity and protections for legitimate providers and patients.

Provenance: The article is based on testimony and exchanges recorded during the Arizona Senate Health and Human Services Committee hearing, including public-comment testimony by Rita Stewart (Turtle Island Women Warriors), Amy Graves (The Haven), and statements from Office of Inspector General head Vanessa Templeman and Access fee-for-service leadership.