A Phoenix-area woman was sentenced to 14 years in prison for her role in fraudulently billing Arizona’s Medicaid agency more than $69 million in less than a year for addiction treatment therapy, the Justice Department announced. Many of the patients used to fuel the scheme were Native Americans covered by Arizona Medicaid under a specific program that reimbursed at higher rates than other Medicaid programs.
In addition to the prison sentence, the defendant was ordered to pay nearly $55 million in restitution and to forfeit almost $9.5 million in fraud proceeds seized from seven bank accounts she controlled, along with nearly $7 million in real estate.
“The Fraud Division is determined to hold accountable individuals who exploit the Medicaid system and Native American health care programs,” said Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division. “This sentence sends a clear message — if you take advantage of vulnerable populations to steal from the American taxpayer, you will pay the price.”
“Ms. Anagho’s scheme manipulated a program that was intended to help Native Americans in Arizona,” said U.S. Attorney Timothy Courchaine for the District of Arizona. “The fourteen-year sentence that she received is a sign of how serious and damaging health care fraud is to our society, and how important it is that we stop individuals who undermine the value of these programs.”
“The FBI will investigate and hold those who target, defraud, and exploit our healthcare programs accountable,” said Special Agent in Charge Rebecca Day of the FBI Phoenix Field Office. “We will continue to work with our partners to stop imposters like Ms. Anagho in their tracks and bring them to justice.”
“Medicaid funds exist to support some of our nation’s most vulnerable individuals. Exploiting this program for personal gain steals taxpayer dollars and undermines a critical safety net relied on by millions,” said Acting Deputy Inspector General for Investigations Miranda L. Bennett of the U.S. Department of Health and Human Services Office of Inspector General. “HHS-OIG and our law enforcement partners will continue to pursue those who defraud Medicaid and ensure they are held fully accountable.”
According to court documents, Rita Ntusa Anagho, 54, of San Tan Valley, Ariz., owned and operated Tusa Integrated Clinic LLC, an addiction treatment center that fraudulently billed the Arizona Health Care Cost Containment System more than $69 million from approximately May 2022 through March 2023. AHCCCS paid the clinic approximately $54.9 million based on those false claims.
Anagho, a licensed nurse practitioner, coordinated and carried out the scheme by exploiting vulnerable substance abuse treatment patients, enrolling those covered by AHCCCS at her clinic. Prosecutors said Anagho and her co-conspirators deliberately targeted AHCCCS patients covered under the American Indian Health Care Program fee-for-service plan available to Native Americans, because that program provided higher reimbursement rates than other AHCCCS health plans. Anagho submitted false claims for purported addiction treatment services that were either not provided at all or not provided as billed, and she and her co-conspirators paid illegal kickbacks to owners of area sober homes in exchange for patient referrals. Anagho and others also falsified treatment notes and records to conceal the scheme, and she later instructed former employees to create fake medical records after her clinic received a subpoena for documents.
Anagho pleaded guilty in May 2025 to conspiracy to commit wire fraud and health care fraud.
The FBI and HHS-OIG investigated the case. Assistant Deputy Chief James V. Hayes and Trial Attorney Sarah Edwards of the Fraud Division’s Health Care Fraud Section, along with Assistant U.S. Attorney Matthew Williams for the District of Arizona, prosecuted the case. Assistant U.S. Attorney Joseph F. Bozdech for the District of Arizona assisted with forfeiture matters.
The case is part of the Justice Department’s broader effort to combat health care fraud. On April 7, the department announced the creation of the National Fraud Enforcement Division, which supports President Trump’s Task Force to Eliminate Fraud, a government-wide initiative chaired by Vice President JD Vance aimed at eliminating fraud, waste and abuse in federal benefit programs. The department’s Health Care Fraud Strike Force Program, now comprising nine strike forces operating across federal districts nationwide, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion since 2007.
By: BSB News wire