$127M Healthcare Fraud: Arizona Operators Face Federal Charges

PHOENIX, Ariz. – Seven individuals are facing federal charges in Arizona as part of a nationwide crackdown on healthcare fraud, announced today by U.S. Attorney Gary M. Restaino. The schemes, totaling an alleged $127.4 million in fraudulent billings to Medicare and Arizona’s Medicaid system (AHCCCS), represent a brazen attempt to siphon funds from vital public health programs.

Rita Anagho, operating through her company Tusa Integrated Clinic LLC (“TUSA”), is accused of fraudulently billing AHCCCS approximately $69.7 million for behavioral healthcare services. The indictment alleges that Anagho specifically targeted the American Indian Health Program (AIHP) and submitted claims for services never rendered or misrepresented. Investigators discovered instances of patients being switched to the AIHP program regardless of their Native American status, a clear exploitation of resources intended for a specific population.

In a parallel case, Daud Koleosho and Adam Mutwol, through Community Hope Wellness Center LLC (“CHWC”), allegedly defrauded AHCCCS out of $57.7 million, also primarily targeting the AIHP. The charges detail a pattern of billing for services not provided and overbilling for those that were, enriching themselves at the expense of vulnerable patients and the program itself.

A separate, disturbing scheme involved Alexandra Gehrke and Jeffrey King, who allegedly targeted elderly Medicare patients, many in hospice care, with medically unnecessary wound grafts. Federal authorities claim these fraudulent claims resulted in over $600 million in improper payments from Medicare and other healthcare benefit programs. The pair were apprehended attempting to flee the country at Sky Harbor International Airport on June 17, 2024.

Attorney General Merrick B. Garland issued a stark warning: “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable.” U.S. Attorney Restaino echoed this sentiment, emphasizing the office’s commitment to pursuing justice “with the utmost vigor” against those who exploit vulnerable populations and steal public funds.

This action in Arizona is part of a larger, two-week nationwide enforcement effort that resulted in criminal charges against 193 defendants for healthcare fraud and opioid abuse schemes, totaling over $2.75 billion in alleged false billings. Authorities have seized over $231 million in assets, including cash, luxury vehicles, and gold, in connection with the operation. The Health Care Fraud Unit’s Strike Forces, alongside multiple U.S. Attorneys’ Offices, collaborated on the investigation.