Evidence record
Arizona Did Not Ensure That Selected Medicaid Managed Care Organizations Complied With Mental Health and Substance Use Disorder Parity Requirements Related to Prior Authorization
- Jurisdiction
- Arizona
- Audit organization
- U.S. Department of Health and Human Services Office of Inspector General
- Publication date
- August 2026
- Source record
- Metadata record
Findings
2
Recommendations
3
Overall conclusion
The State agency did not ensure that all selected MCOs conducted annual parity analyses and adequately oversight; as a result, parity compliance could not be confirmed, potentially delaying or obstructing MH/SUD treatment for Medicaid enrollees.
Scope
Audit period October 1, 2022, through September 30, 2023; review of state oversight of three Medicaid MCOs serving about 1.9 million enrollees, assessing whether parity analyses of MH/SUD benefits and related prior authorization were conducted and documented.
Findings (2)
Each finding has a stable link.
- F-1334
Two of the three selected Medicaid MCOs did not perform annual parity analyses and were unable to demonstrate compliance with parity requirements related to the prior authorization of MH/SUD services.
- F-1335
The State agency's oversight did not adequately ensure that MCOs complied with parity requirements; policies were unclear and relied on attestations rather than focused reviews of parity analyses and supporting data.
Recommendations (3)
- R-1187
Clarify that MCOs are required to annually perform parity analyses.
Related finding F-1335 - R-1188
Require MCOs to submit the results of parity analyses with reliable supporting documentation (e.g., data) for the State agency's review.
Related finding F-1334 - R-1189
Review the MCOs' annual parity analyses and supporting documentation.
Related finding F-1335