A 54-year-old nurse practitioner, Rita Anagho, has been sentenced to 14 years in federal prison after being convicted in connection with a Medicaid fraud scheme that prosecutors said caused more than $69 million in losses to Arizona’s healthcare programme.
Anagho, a resident of San Tan Valley, Arizona, owned and operated Tusa Integrated Clinic, an addiction treatment facility. According to court records and the U.S. Department of Justice, she 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 those claims.
Prosecutors alleged that Anagho targeted vulnerable patients receiving substance abuse treatment, including Native Americans enrolled in the American Indian Health Care Programme, because the programme provided higher reimbursement rates for certain addiction treatment services.
The government alleged that she billed AHCCCS for services that were not provided and overstated other services to obtain higher reimbursements. Prosecutors also alleged that she worked with sober-home operators to refer patients to the clinic and shared proceeds from the scheme with them.
According to the evidence presented in court, Anagho and her co-conspirators paid illegal kickbacks to owners of several sober homes in exchange for patient referrals. Prosecutors further alleged that, after the clinic received a subpoena for records, Anagho directed former employees to create false medical records to support the claims.
Following her conviction, the court sentenced Anagho to 14 years in prison and ordered her to pay $55 million in restitution. Authorities also seized $9.5 million from seven bank accounts linked to her, while the court ordered the forfeiture of nearly $7 million in real estate to the U.S. government.
