ARIZONA ADDICTION CLINIC OWNER SENTENCED TO 14 YEARS IN $69 MILLION MEDICAID FRAUD SCHEME

PHOENIX, Ariz. — The owner of an Arizona addiction-treatment clinic has been sentenced to 14 years in federal prison for leading a Medicaid fraud scheme that generated more than $69 million in false claims in less than one year, including claims tied to Native American patients enrolled through Arizona’s American Indian Health Program.

Rita Ntusa Anagho, 54, of San Tan Valley, owned and operated Tusa Integrated Clinic LLC, an addiction-treatment center that federal prosecutors said fraudulently billed the Arizona Health Care Cost Containment System, or AHCCCS, more than $69 million between approximately May 2022 and March 2023. AHCCCS paid the clinic approximately $54.9 million based on false and fraudulent claims.

In addition to the prison sentence, Anagho was ordered to pay nearly $55 million in restitution.

The court also ordered the forfeiture of almost $9.5 million in fraud proceeds seized from seven bank accounts under her control and nearly $7 million in real estate properties connected to the proceeds of the scheme.

Anagho, a licensed nurse practitioner, pleaded guilty in May 2025 to conspiracy to commit wire fraud and health care fraud.

According to federal court documents, she coordinated the scheme through Tusa while targeting patients whose treatment was covered through Arizona Medicaid.

Prosecutors said Anagho and her co-conspirators specifically sought patients enrolled through the American Indian Health Program, or AIHP, a fee-for-service Medicaid program available to eligible Native American members.

Federal prosecutors said the defendants pursued those patients because the AIHP reimbursed certain treatment services at higher rates than other AHCCCS plans.

AHCCCS confirms that AIHP operates through its Division of Fee-for-Service Management, which reimburses enrolled providers for covered services provided to qualifying members.

The scheme relied on claims for addiction-treatment services that prosecutors said were either never provided or were not provided in the manner represented on the claims.

Anagho and others also falsified treatment notes and medical records to make the billed services appear legitimate.

Federal prosecutors said the operation went beyond improper billing.

Anagho and her co-conspirators paid illegal kickbacks to owners of sober-living homes in exchange for referring patients to Tusa.

Those referrals helped supply the clinic with Medicaid beneficiaries whose identities and coverage could then be used to support additional claims.

The use of patient referrals as part of a kickback arrangement added another layer to the fraud because addiction-treatment patients were treated as a source of reimbursement rather than as individuals seeking legitimate medical care.

The Department of Justice said many of the patients involved were Native Americans whose coverage was provided through the AIHP program.

The financial scale grew rapidly.

During a period covering less than one year, Tusa submitted more than $69 million in claims to AHCCCS and received approximately $54.9 million.

That means the overwhelming majority of the clinic’s claimed reimbursement activity during the charged period produced actual Medicaid payments before the scheme was stopped.

Prosecutors also established that Anagho attempted to conceal the operation after investigators began examining the clinic.

When Tusa received a subpoena seeking records, Anagho instructed former employees to create fake medical records in an effort to obstruct the investigation.

The scheme also included laundering proceeds generated by the fraudulent billing.

The forfeiture portion of the sentence shows how those proceeds moved beyond ordinary clinic operations.

Federal authorities recovered millions of dollars across seven bank accounts and identified nearly $7 million in real estate subject to forfeiture.

Forfeiture and restitution serve different functions in a federal criminal case.

Restitution is intended to compensate victims for losses caused by the offense, while criminal forfeiture removes property or proceeds connected to criminal conduct.

The court imposed both: nearly $55 million in restitution and forfeiture covering millions more in bank and real-estate assets.

The case was investigated by the FBI and the U.S. Department of Health and Human Services Office of Inspector General, with substantial assistance from the AHCCCS Office of Inspector General.

The FBI’s Phoenix Field Office participated in the investigation.

Assistant Deputy Chief James V. Hayes and Trial Attorney Sarah Edwards of the Justice Department’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 handled forfeiture matters.

The federal case is identified as United States v. Anagho, Case No. 24-CR-01044-PHX-MTL in the District of Arizona.

The case falls within a broader federal effort against health care fraud.

The Justice Department said its Health Care Fraud Strike Force Program currently consists of nine strike forces operating across multiple federal judicial districts and that, since 2007, the program has charged more than 6,200 defendants accused of collectively billing federal health care programs and private insurers more than $45 billion.

The Department also established its National Fraud Enforcement Division in 2026 to coordinate broader fraud investigations involving federal programs. The DOJ describes the division as part of its effort to investigate and prosecute fraud against taxpayer-funded systems.

The scale of the Anagho case stands out because the fraudulent billing was concentrated into such a short period.

More than $69 million in claims were submitted between roughly May 2022 and March 2023, while nearly $55 million was actually paid.

The scheme also crossed several forms of misconduct at once: false billing, patient recruitment through kickbacks, fabricated treatment documentation, money laundering, and obstruction through the creation of false medical records.

Anagho was sentenced to 14 years in federal prison and ordered to pay nearly $55 million in restitution, with additional forfeiture involving bank funds and real estate.

At its center was a program created to provide health care to eligible Native American patients.

Federal prosecutors established that the system was instead used as a source of fraudulent reimbursement, with vulnerable addiction-treatment patients placed at the center of a scheme that generated tens of millions of dollars before federal investigators intervened.

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