A 54-year-old nurse practitioner, Rita Anagho, has been sentenced to 14 years in prison for using her addiction treatment clinic, Tusa Integrated Clinic, to defraud Arizona’s Medicaid agency of more than $69 million.
Anagho, who lives in San Tan Valley, Arizona, owned and operated the clinic and fraudulently billed 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 fraudulent claims.
According to the U.S. Department of Justice, Anagho targeted vulnerable substance abuse patients, particularly Native Americans enrolled in the American Indian Health Care Programme (AIHP) fee-for-service plan, because it offered higher reimbursement rates for addiction treatment services.
She allegedly billed the government for services that were not provided and exaggerated others to obtain higher payments. She also worked with sober homes to refer substance abuse patients to her clinic and shared proceeds from the scheme with them.
The court said Anagho and her co-conspirators also paid illegal kickbacks to owners of several sober homes for patient referrals. After Tusa Integrated Clinic was subpoenaed for documents, 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.
