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State v. Ms. G (DMC No. 13474)

State v. Ms. G (DMC No. 13474) – Felony Benefits Fraud ($13,700 Misappropriated from AHCCCS) and Felony Fraudulent Schemes – Not Charged – Department of Economic Security and Family Assistance Division Investigated.

Ms. G only had a high school education and was working part-time at a Subway sandwich shop as a sandwich maker. She had multiple health issues which included Type I diabetes, cystic fibrosis, depression, asthma, PTSD, etc. Many of these ailments rendered her partially disabled and she needed assistance from AHCCCS (Arizona Health Care Cost Containment System) in order to received medical care and medication.

While applying for AHCCCS benefits, she did not list all of her income. She omitted the fact that she had a $28,000 annuity/life insurance policy that was left to her by her grandfather. For several years while she was on AHCCCS, she made several withdrawals totaling $13,700, which was a violation of AHCCCS rules and the statute under A.R.S. 23-785. Ms. G suddenly received a letter from DES and the Family Assistance Division asking for an interview as they were conducting an investigation triggered by that annuity.

Once we became involved, we contacted the Investigator for DES and began revealing her total income. We also showed that these draws (spread out over several years) would not have affected her eligibility to receive AHCCCS benefits. Ultimately, AHCCCS agreed to allow her to reapply for benefits with the full disclosure of the balance of the annuity being revealed. Originally, she could have been charged with a very serious felony and lost her medical benefits. However, she was never charged and was able to continue getting her medical treatment and her medications.

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