6) PAS Changes

Official source

A) The customer was initially applied in 2010 at 7 years old. His Initial PAS summary noted that he was on the Autism Spectrum, had Developmental Delays, but was dependent with daily activities with "set up" assistance. He was able to communicate, has no aggression or disruptive behavior, but would "verbally self-harm" by "saying" he would hit himself. He scored a 42.25 on his PAS.

AHCCCS OIG received a referral that his caregiver had submitted claims for services not rendered and there was a possibility of the customer living in another country; indicating that he may no longer be eligible for ALTCS. No reassessments were completed in 15 years. When the customer was reassessed in 2025, at the age of 21, he was scored 22.4 and no longer eligible for ALTCS.

B) The customer was initially assessed in 2015 and approved as she was left partially paralyzed after suffering a stroke in 2014. Other medical conditions were also noted. She was approved with a score of 67.50. The OIG received a referral indicating her financial and medical situation may have changed. It was also alleged her caretaker was more of a housekeeper/maid and not actually providing services. A home visit was conducted. The investigators found her fully ambulatory without any walking aides or slurred speech. The AHCCCS OIG requested a reassessment, 9 years after her initial approval. She scored a 43 and was placed on Transitional coverage.

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6) PAS Changes

Official source

A) The customer was initially applied in 2010 at 7 years old. His Initial PAS summary noted that he was on the Autism Spectrum, had Developmental Delays, but was dependent with daily activities with "set up" assistance. He was able to communicate, has no aggression or disruptive behavior, but would "verbally self-harm" by "saying" he would hit himself. He scored a 42.25 on his PAS.

AHCCCS OIG received a referral that his caregiver had submitted claims for services not rendered and there was a possibility of the customer living in another country; indicating that he may no longer be eligible for ALTCS. No reassessments were completed in 15 years. When the customer was reassessed in 2025, at the age of 21, he was scored 22.4 and no longer eligible for ALTCS.

B) The customer was initially assessed in 2015 and approved as she was left partially paralyzed after suffering a stroke in 2014. Other medical conditions were also noted. She was approved with a score of 67.50. The OIG received a referral indicating her financial and medical situation may have changed. It was also alleged her caretaker was more of a housekeeper/maid and not actually providing services. A home visit was conducted. The investigators found her fully ambulatory without any walking aides or slurred speech. The AHCCCS OIG requested a reassessment, 9 years after her initial approval. She scored a 43 and was placed on Transitional coverage.