FAA6.F Administrative : 05 Office of Special Investigations (OSI)/AHCCCS Office of Inspector General (AOIG)
05 Office of Special Investigations (OSI)/AHCCCS Office of Inspector General (AOIG)
 
(01/01/18 – 12/31/18)
The general public, employees, and participants may submit a request to investigate potential fraud. When this occurs, the following departments are responsible for acting upon the request:
 
 
OSI and AOIG have the authority to access case files(g), and administrative records.
 
OSI conducts the following investigations:
 
Pre-approval investigations on participants to prevent potential fraud for the following programs:
All CA, NA, and MA combo cases throughout the state.
Post-approval investigations on participants already receiving benefits, to stop potential fraud.
 
AOIG conducts the following investigations on MA only (MAO) cases:
 
Pre-approval investigations
Post-approval investigations for all counties when both of the following apply:
Evidence that potential fraud occurred during the current or previous application period (initial or renewal).
MA is the only program.
 
Policy and procedures regarding referrals to OSI are outlined as follows: