A 54-year-old nurse practitioner, Rita Anagho, has been sentenced to 14 years in prison for her role in a scheme that defrauded Arizona’s Medicaid agency of more than $69 million through her addiction treatment clinic.
Anagho, a resident of San Tan Valley, Arizona, owned and operated Tusa Integrated Clinic, which allegedly submitted fraudulent claims to the Arizona Health Care Cost Containment System (AHCCCS) between May 2022 and March 2023. The agency paid the clinic approximately $54.9 million based on the claims.
According to the U.S. Department of Justice, Anagho targeted vulnerable patients receiving substance abuse treatment, particularly Native Americans enrolled in the American Indian Health Care Programme, which provided higher reimbursement rates for addiction treatment services.
Prosecutors said she billed the government for services that were never provided and inflated other claims to receive higher reimbursements. She also allegedly partnered with sober homes to refer substance abuse patients to her clinic and shared proceeds from the scheme with them.
The court heard that Anagho and her co-conspirators paid illegal kickbacks to operators of several sober homes in exchange for patient referrals.
After Tusa Integrated Clinic was subpoenaed for records, Anagho allegedly instructed former employees to create fake medical records to make the fraudulent claims appear legitimate.
In addition to the 14-year prison sentence, the court ordered Anagho to pay $55 million in restitution. Authorities also seized $9.5 million from seven bank accounts linked to her and ordered her to forfeit nearly $7 million worth of real estate to the U.S. government.
