A 54-year-old nurse practitioner, Rita Anagho, has been sentenced to 14 years in prison for her role in a healthcare fraud scheme involving more than 69 million dollars in Medicaid funds in the United States.
Anagho, a resident of San Tan Valley, Arizona, was the owner and operator of Tusa Integrated Clinic, an addiction treatment facility accused of submitting fraudulent claims to the Arizona Health Care Cost Containment System (AHCCCS) between May 2022 and March 2023.
The clinic reportedly received about 54.9 million dollars from AHCCCS based on the claims.
According to the U.S. Department of Justice, Anagho targeted vulnerable people receiving substance abuse treatment, including Native Americans enrolled in the American Indian Health Care Programme, which provided higher reimbursement rates for certain addiction treatment services.
Prosecutors said Anagho billed the government for medical services that were not provided and inflated claims for services that were rendered in order to obtain higher reimbursements.
She was also accused of working with operators of sober homes to recruit substance abuse patients for her clinic and sharing proceeds from the scheme with them.
The court heard that Anagho and her co-conspirators paid illegal kickbacks to owners of several sober homes in exchange for patient referrals.
After authorities subpoenaed Tusa Integrated Clinic for records, Anagho allegedly directed former employees to create false medical records to support the fraudulent claims and make them appear legitimate.
In addition to the 14-year prison sentence, the court ordered Anagho to pay 55 million dollars in restitution.
Authorities also seized 9.5 million dollars from seven bank accounts linked to her and ordered the forfeiture of nearly seven million dollars worth of real estate to the U.S. government.
The case highlights ongoing efforts by U.S. authorities to combat healthcare fraud and protect public healthcare funds from abuse.
