Nurse Practitioner Guilty in $54M Medicaid Fraud Exploiting Native Americans

Rita Anagho, a 52-year-old former nurse practitioner from San Tan Valley, Arizona, recently pleaded guilty to orchestrating one of the largest Medicaid fraud schemes in the state’s history. Anagho was the owner and operator of Tusa Integrated Clinic LLC, an outpatient behavioral health and addiction treatment center that enrolled as a provider with the Arizona Health Care Cost Containment System (AHCCCS), the state’s Medicaid agency.

Details of the Scheme

According to court documents, Anagho submitted false and fraudulent claims to AHCCCS from Tusa Integrated Clinic, totaling nearly $69 million. The fraudulent activity primarily targeted the American Indian Health Program (AIHP), a Medicaid program designed to serve Native American communities. The scheme involved billing for services that:

• Were never provided to patients
• Were not provided as billed
• Were so substandard they failed to serve any legitimate treatment purpose
• Were not integrated into any patient’s treatment plan
• Were medically unnecessary

Anagho further compounded the fraud by instructing former employees to fabricate therapy notes for sessions that never occurred, especially after being served with a subpoena for clinic records as part of the federal investigation.

The fraudulent activities not only defrauded taxpayers but also exploited some of Arizona’s most vulnerable populations. Many of the patients were Native Americans recruited under the guise of receiving addiction treatment. In some cases, patients were referred from so-called “sober living homes” that were, in reality, sham operations. These patients, expecting legitimate care, were instead used as pawns in a scheme that sometimes left them worse off, with some returning to substance use disorders such as fentanyl addiction.

Legal Proceedings and Charges

Anagho was indicted on June 18, 2024, on multiple federal charges, including:

• Conspiracy to commit health care fraud and wire fraud
• Health care fraud
• Transactional money laundering
• Obstruction of a health care fraud investigation

She was detained pending trial, and on May 29, 2025, she changed her plea to guilty as part of ongoing proceedings in federal court.

Rita Anagho’s cause is a sobering example of how healthcare fraud schemes can devastate both public resources and vulnerable patients. Nurses play a crucial role in safeguarding ethical standards and protecting patient welfare. Staying informed, maintaining integrity in practice, and speaking up against wrongdoing are essential responsibilities for every nurse.

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