Attorney General Mayes Announces Behavioral Health Fraud Sentence, Reveals Dramatic Decrease in Behavioral Health Code Billing after Fraud Crackdown

PHOENIX — Attorney General Mayes today announced the sentencing of Rita Anagho, in a fraud case resulting from the office's ongoing effort to combat fraudulent billing schemes that targeted the state's Medicaid program and exploited vulnerable Native Americans struggling with addiction — people who sought help and were instead trafficked for financial gain.

"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," said Attorney General Mayes. "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. We will continue to pursue individuals and entity that participated in this fraud."

Since exposing these fraud schemes in May of 2023, Attorney General Mayes has relentlessly pursued criminal enterprises that billed the Arizona Health Care Cost Containment System (AHCCCS) for behavioral health services that were never provided — or were provided under exploitative conditions — while trafficking Native Americans to unlicensed sober living homes across the Valley.

Rita Anagho Sentencing

Ms. Anagho engaged in fraudulent billing schemes targeting Arizona's Medicaid program (AHCCCS), including billing for behavioral health services never rendered, billing for services provided to minors who received no care, billing for incarcerated and deceased members, and coercing AHCCCS members to change health plans under threat of removal from unlicensed sober living homes.

Anagho, a nurse practitioner, operated TUSA Integrated Clinic (TUSA) and served as the Behavioral Health Professional for as many as 10 to 15 other behavioral health facilities — many of which have since been suspended or terminated.

TUSA engaged in a systematic pattern of fraudulent billing, submitting claims for services never provided, including to minor patients, incarcerated individuals, and deceased members, while specifically targeting the Native American and American Indian population.

Anagho's scheme deprived legitimate Medicaid beneficiaries of critical resources and, by exploiting an already vulnerable population, helped fuel Arizona's large-scale behavioral health crisis.

Ms. Anagho was sentenced to 3.5 years in prison on May 6, 2026, Maricopa County Superior Court after entering a guilty plea. 

In a separate federal case against Anagho, she was ordered to pay $55 million in restitution and is awaiting sentencing in that case. Ms. Anagho’s nursing license was also revoked last year.

Fraudulent Billing Drops Dramatically After AG Mayes’ Enforcement Actions

The sentencing announced today is just one case among many that represent the measurable impact of the Attorney General's sustained enforcement effort. Fraudulent behavioral health billing to AHCCCS has declined sharply since AG Mayes ramped up criminal prosecutions beginning in 2023.

During the period from 2021 to 2023, AHCCCS recorded approximately $3,114,163,966 in behavioral health code billing in the American Indian Health Plan. Since the Attorney General's office launched its aggressive enforcement actions in 2023, that billing has dropped to approximately $229,942,919 from 2024 to 2026 — a 92% decline.

Since 2023, Attorney General Mayes has:

• Indicted 140 individuals and entities related to these fraud schemes
• Convicted 41 individuals and/or entities
• Recovered or seized more than $139 million in cash and real property
• Worked with AHCCCS to put in place guardrails and measures to prevent fraudulent billing

Background:

Beginning in 2020, Arizona saw a dramatic surge in billing for outpatient behavioral health services to the American Indian Health Plan (AIHP) under AHCCCS, the state's Medicaid program. Investigators found that criminal enterprises — many operating unlicensed sober living homes — were recruiting Native Americans from tribal communities across the Southwest, transporting them to Valley homes, and billing AHCCCS for services that were never rendered or were provided under exploitative, dangerous conditions.

In May 2023, Governor Katie Hobbs and Attorney General Mayes announced coordinated state action, with AHCCCS suspending payments to approximately 100 Medicaid providers based on credible fraud allegations. Attorney General Mayes called the scandal one of the most significant in state history, with estimated losses to Arizona's Medicaid program reaching into the billions.