Mesa Residents Sentenced to Federal Prison in $3.3 Million Medicaid Fraud Scheme Targeting Arizona Health Program

Two Mesa residents have been sentenced in federal court for orchestrating a healthcare fraud scheme that targeted Arizona’s Medicaid system and generated millions of dollars in fraudulent reimbursements.

Eric Riley, 39, and Britney Gooch, 38, both of Mesa, Arizona, were sentenced by United States District Judge Krissa M. Lanham after pleading guilty to healthcare fraud connected to a behavioral health clinic they operated.

Riley was sentenced on February 6, 2026, to 24 months in federal prison, while Gooch was sentenced on February 20, 2026, to 12 months and one day in federal prison. The defendants were also ordered to pay $3.3 million in restitution to the Arizona Health Care Cost Containment System (AHCCCS), the state agency responsible for administering Arizona’s Medicaid program.

Behavioral Health Clinic Used in Fraud Scheme

According to federal prosecutors, Riley and Gooch operated New Horizons Behavioral Health, a clinic based in Mesa that provided behavioral health services billed through Arizona’s Medicaid system.

Investigators determined that between 2020 and 2022, the defendants exploited AHCCCS’s American Indian Health Program (AIHP) by submitting fraudulent claims for behavioral health services that were never provided to patients.

The AIHP program allows eligible American Indian and Alaska Native individuals to receive services through the Medicaid system, with reimbursement structures designed to improve healthcare access for tribal communities.

Federal authorities stated that Riley and Gooch used their clinic to submit false billing claims under the AIHP program, falsely representing that services had been provided to eligible patients. In reality, investigators found that many of the billed services never occurred.

As a result of these fraudulent submissions, the clinic received approximately $3.3 million in payments from AHCCCS.

Federal Medicaid Fraud Enforcement

Medicaid fraud investigations typically involve forensic financial analysis, claims auditing, and coordination between state healthcare agencies and federal investigators. Fraud schemes often include billing for services not rendered, falsifying patient treatment records, or inflating billing codes to generate higher reimbursements.

Programs designed to provide healthcare access to underserved populations can be particularly vulnerable to fraud when providers manipulate documentation or exploit reimbursement structures.

In this case, investigators determined that the defendants’ fraudulent claims diverted significant public healthcare funds away from legitimate medical services intended for eligible patients.

Investigation and Prosecution

The case was investigated by the Federal Bureau of Investigation (FBI) Phoenix Field Office, with substantial assistance from the Arizona Health Care Cost Containment System Office of Inspector General (AHCCCS-OIG).

Federal prosecutors emphasized that Medicaid fraud cases frequently require coordination between federal law enforcement and state healthcare oversight agencies due to the complexity of billing systems and reimbursement structures.

The case was prosecuted by the United States Attorney’s Office for the District of Arizona in Phoenix.

Court records identify the case as United States v. Riley et al., Case No. CR-24-01794.

Financial Accountability in Healthcare Programs

Federal authorities noted that healthcare fraud directly impacts taxpayer-funded programs designed to provide medical care to vulnerable populations.

Medicaid fraud enforcement remains a priority across the United States, with federal agencies regularly pursuing cases involving behavioral health clinics, medical providers, and billing companies that manipulate healthcare reimbursement systems.

The restitution order issued in this case is intended to recover the full amount of fraudulent payments received through the scheme.

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