CoEric Riley, Healthcare Fraud, Arizona 2024

Two Arizonans have been caught in a massive healthcare fraud scheme targeting the Arizona Health Care Cost Containment System (AHCCCS), Arizona's Medicaid agency. CoEric Riley, 38, of Mesa, pleaded guilty to Healthcare Fraud on Tuesday, while his co-defendant, Britney Gooch, 37, of Mesa, also pleaded guilty to the same crime on November 21, 2024.

Riley and Gooch admitted that they defrauded AHCCCS through their company New Horizons Behavioral Health, a behavioral health clinic in Mesa, Arizona. They exploited AHCCCS's American Indian Health Program by falsely billing for services that were not provided to patients enrolled in the program.

As a result of the fraudulent billing submissions, Riley and Gooch obtained approximately $3.3 million in illegitimate proceeds from AHCCCS. A conviction for Healthcare Fraud carries a maximum penalty of 10 years in prison and a fine of up to $250,000, or both.

Riley and Gooch are scheduled to be sentenced on February 21, 2025, before United States District Judge Krissa M. Lanham.

The Federal Bureau of Investigation - Phoenix Division conducted the investigation in this case. The United States Attorney's Office, District of Arizona, Phoenix, is handling the prosecution.

AHCCCS is Arizona's Medicaid agency, responsible for providing health care coverage to low-income individuals and families. The agency's American Indian Health Program provides health care services to American Indians and Alaska Natives living in Arizona.

Riley and Gooch's scheme highlights the importance of monitoring and preventing healthcare fraud. The case also underscores the need for increased oversight and accountability within healthcare organizations to prevent such schemes from occurring in the future.

Source: https://www.justice.gov/usao-az/pr/two-arizonans-plead-guilty-fraud-targeting-ahcccs