A 54-year-old nurse practitioner, Rita Anagho, has been sentenced to 14 years in prison for allegedly defr@uding Arizona’s Medicaid agency of more than $69 million through her addiction treatment clinic.
Anagho, who lives in San Tan Valley, Arizona, owned and operated Tusa Integrated Clinic, which allegedly submitted fr@udulent 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 substance @buse patients, particularly Native Americans enrolled in the American Indian Health Care Programme, which offered higher reimbursement rates for addiction treatment services.
She was accused of billing the government for services that were not provided and exaggerating others to obtain higher payments. She also allegedly worked with sober homes to refer substance @buse patients to her clinic and shared proceeds from the scheme with them.
The court heard that Anagho and her co-conspirators paid illegal k!ckbacks to owners of several sober homes in exchange for patient referrals.
After Tusa Integrated Clinic was subpoenaed for documents, Anagho allegedly instructed former employees to create f@ke medical records to make the fr@udulent 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.