Arizona Health Care Cost Containment System - Coordination of Benefits

AHCCCS has established various processes for identifying members with other health insurance, ensuring these other insurers first pay for a member's medical costs, and recovering monies from other liable parties after members' healthcare costs have been paid. However, AHCCCS can implement additional oversight procedures and use federal data to further help ensure it pays for medical benefits only after other responsible parties have first paid their share. Further, AHCCCS should establish an additional oversight procedure of its post-payment recovery contractor, document decisions to accept less than the settlement amount recommended by its contractor, and seek additional data-sharing agreements to enhance its recoveries.