By admin 
PHOENIX (AZFamily) — A nurse practitioner will spend 3.5 years in prison for her role in a Medicaid fraud case tied to Arizona’s behavioral health care scandal.
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Rita Anagho was sentenced May 6 in Maricopa County Superior Court after pleading guilty in the case, according to Arizona Attorney General Kris Mayes.
Mayes’ office said Anagho operated TUSA Integrated Clinic and worked as the behavioral health professional for as many as 10 to 15 other behavioral health facilities. Many of those facilities have since been suspended or shut down.
Prosecutors said Anagho and TUSA billed Arizona’s Medicaid program, known as AHCCCS, for behavioral health services that patients never received.
The false claims included billing for children who received no care, people who were incarcerated and members who had died.
Anagho was also accused of pressuring AHCCCS members to switch health plans by threatening to kick them out of unlicensed sober living homes.
“For the past three years, my office has made it a top priority to hunt down and prosecute the criminals who stole from Arizona’s Medicaid program while exploiting some of our most vulnerable residents,” Mayes said in a statement. “And billing to the programs targeted in this scheme has dropped by an astonishing 92% since we launched our fraud crackdown. We are not done.”
Anagho is also facing a separate federal case. Mayes’ office said she has been ordered to pay $55 million in restitution and is still awaiting sentencing in that case. Her nursing license was revoked last year.
Officials point to wider enforcement effort
The case is part of a broader enforcement effort announced in 2023, when state leaders said fraudulent behavioral health and sober living providers were taking advantage of tribal community members and billing Arizona’s Medicaid program for millions of dollars.
Officials said many victims were recruited from tribal lands with promises of help for addiction treatment. Instead, investigators said they were brought to the Valley and exploited while providers billed AHCCCS for services that were never provided or were not properly delivered.
After the allegations surfaced, the state announced several changes, including an outside audit of mental health and addiction treatment claims dating back to 2019. Officials also put new systems in place to flag suspicious claims and improve fraud detection.
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AHCCCS later suspended payments to more than 100 providers while investigations continued.
Since prosecutions ramped up in 2023, officials said fraudulent behavioral health billing has dropped sharply.
From 2021 to 2023, AHCCCS recorded about $3.1 billion in behavioral health billing under the American Indian Health Plan. From 2024 to 2026, that dropped to about $229.9 million, a 92% decline, according to the attorney general’s office.
Since 2023, Mayes’ office said it has indicted 140 people and businesses connected to the fraud schemes and secured convictions against 41 people and/or entities.
Of those indicted, 89 have pleaded guilty, been sentenced or reached a court-approved settlement favorable to the state.
The attorney general’s office said more than $139 million in cash and real estate has been recovered or seized.
Officials also said they have worked with AHCCCS to add safeguards meant to prevent fraudulent billing in the future.
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