PHOENIX, Ariz. – Today, United States Attorney Gary M. Restaino announced criminal charges against seven defendants in connection with alleged schemes to defraud Medicare and Medicaid (specifically AHCCCS, the Arizona Health Care Cost Containment System). The charges filed in federal court are part of the Department of Justice’s 2024 National Health Care Fraud Enforcement Action.
The charges in these cases stem from schemes to obtain, in the aggregate, hundreds of millions of dollars in fraudulent billings. For example, Rita Anagho, acting primarily though her company, Tusa Integrated Clinic LLC (“TUSA”), was charged for fraudulently billing AHCCCS approximately $69.7 million for behavioral healthcare services. ANAGHO primarily targeted AHCCCS’s American Indian Health Program (“AIHP”) and billed for services that were never provided or not provided as represented. AHCCCS provides health care services to Native Americans through AIHP, and there has been widespread fraud reported in which residential and outpatient treatment centers recruited Native Americans and other individuals to exploit the AIHP under AHCCCS. Many of the patients recruited for TUSA were Native Americans or other individuals who were enrolled in AIHP, and in some cases, patients were switched from their existing AHCCCS insurance plan to AIHP, regardless of whether the patient was Native American.
In another matter, Daud Koleosho and Adam Mutwol, acting primarily though their company, Community Hope Wellness Center LLC (“CHWC”), fraudulently billed AHCCCS approximately $57.7 million for behavioral health care services. They too primarily targeted the AIHP, billed AHCCCS for services that were never provided, and overbilled for services that were provided, all to the detriment of the AIHP.
In another case, Alexandra Gehrke and Jeffrey King were charged for targeting elderly Medicare patients, many of whom were terminally ill in hospice care, for medically unnecessary wound grafts. Medicare and other health care benefit programs paid over $600 million based on the false and fraudulent claims they submitted for these vulnerable beneficiaries. Gehrke and King were arrested on June 17, 2024, at Sky Harbor International Airport as they were attempting to board a flight out of the country.
“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,” said Attorney General Merrick B. Garland. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.”
“These cases involve not just massive fraud to steal public funds, but also exploitation of vulnerable victims and the misappropriation of resources earmarked for Native American communities,” said U.S. Attorney Restaino. “The U.S. Attorney’s Office and our investigative partners will pursue justice against those who perpetrate these sorts of schemes with the utmost vigor.”
The charges announced today by U.S. Attorney Restaino are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets.
The Health Care Fraud Unit’s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys’ Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals’ Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit’s Data Analytics Team. Descriptions of each case involved in today’s enforcement action are available on the Department’s website here.
“We will not tolerate fraud that preys on patients who need and deserve high quality health care,” said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG). “The hard work of the HHS-OIG team and our outstanding law enforcement partners makes today’s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.”
“Fraud against government funded health care systems not only costs taxpayers billions each year, but as we’ve seen in Arizona, deprives critical care and benefits for our most vulnerable populations,” said Brian Driscoll, acting special agent in charge of the FBI’s Phoenix Field Office. “People who participate in this type of fraud will continue to catch the eye of the FBI.”
The following individuals have been charged in the District of Arizona as part of this National Enforcement Action:
• Alexandra Gehrke, charged by indictment on June 18, 2024; CR-24-01040-PHX-ROS
• Jeffery King, charged by indictment on June 18, 2024; CR-24-01040-PHX-ROS
• Bethany Jameson, charged by information June 24, 2024; CR-24-01068-PHX-DWL
• Carlos Ching, charged by information June 24, 2024; CR-24-01075-PHX-MTL
• Rita Anagho, charged by indictment on June 18, 2024; CR-24-01044-PHX-MTL
• Adam Mutwol, charged by information June 25, 2024; CR-24-01097-PHX-SPL
• Daud Koleosho, charged by information June 25, 2024; CR-24-01098-PHX-MTL
Alexandra Gehrke, 38, and Jeffrey King, 49, of Scottsdale, were charged by indictment with conspiracy, health care fraud, receiving kickbacks, and money laundering in connection with an alleged scheme to fraudulently bill Medicare $900 million for highly expensive amniotic allografts. The defendants targeted elderly Medicare patients, many of whom were terminally ill in hospice care, through their companies—Apex Mobile Medical LLC, Apex Medical LLC, Viking Medical Consultants LLC, and APX Mobile Medical LLC. The defendants caused unnecessary and extremely expensive amniotic grafts to be applied to these vulnerable patients’ wounds indiscriminately, without coordination with the patients’ treating physicians, without proper treatment for infection, to superficial wounds that did not need this treatment, and in sizes excessively larger than the wound. In just sixteen months, Medicare paid the defendants more than $600 million as a result of their fraud scheme, paying on average more than a million dollars per patient for these unnecessary grafts. The defendants received more than $330 million in illegal kickbacks from the graft distributor in exchange for purchasing and ordering the grafts billed to Medicare. Significant assets were seized upon the defendants’ arrests, including luxury vehicles, gold, and bank accounts totaling more than $70 million. The case is being prosecuted by Trial Attorney Shane Butland of the National Rapid Response Strike Force and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
Bethany Jameson, 53, of Gilbert, is charged by information with conspiracy to commit wire fraud in connection with the APX scheme. As alleged in the information, Jameson was paid by Apex Mobile Medical and APX to apply medically unnecessary allografts to Medicare beneficiaries that were procured through kickbacks and bribes. Between November 2022 and August 2023, Apex Mobile Medical and APX billed Medicare over $71 million for allografts applied by Jameson. Medicare paid over $49 million based on those false and fraudulent claims. The case is being prosecuted by Trial Attorney Shane Butland of the National Rapid Response Strike Force and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
Carlos Ching, 55, of Phoenix, is charged by information with conspiracy to commit health care fraud in connection with the APX scheme. As alleged in the information, Ching was paid by APX to apply medically unnecessary allografts to Medicare patients that were procured through kickbacks and bribes. Between June 2023 and January 2024, APX fraudulently billed Medicare over $87 million for allografts applied by Ching. Medicare paid APX over $65 million based on those false and fraudulent claims. And from January 2024 through March 2024, Ching, through his company H3 Medical Clinic LLC, billed Medicare over $5 million for allografts that he procured through kickbacks and bribes and applied to Medicare beneficiaries without medical necessity. Medicare paid over $4 million based on those false and fraudulent claims. The case is being prosecuted by Trial Attorney Shane Butland of the National Rapid Response Strike Force and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
Rita Anagho, 52, of San Tan Valley, was charged by indictment with conspiracy to commit health care fraud, health care fraud, money laundering, and obstruction of justice in connection with an alleged $69 million scheme involving a substance abuse treatment clinic in Arizona. As alleged in the indictment, Anagho owned Tusa Integrated Clinic LLC (“Tusa”), an outpatient treatment center, which was purportedly in the business of providing addiction treatment services for persons suffering from alcohol and drug addiction. Tusa enrolled as a provider with Arizona’s Medicaid agency, Arizona Health Care Cost Containment System, and submitted false and fraudulent claims for services that were not provided, were not provided as billed, were so substandard that they failed to serve a treatment purpose, were not used as part of any treatment plan, and were medically unnecessary. Anagho also instructed former Tusa employees to create false therapy notes for sessions they did not conduct in 2023 after she was served with a subpoena for Tusa’s records as part of the government’s investigation of this fraud. The case is being prosecuted by Assistant Chief James Hayes and Trial Attorney Sarah Edwards of the National Rapid Response Strike Force and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
Adam Mutwol, 45, of Tempe, and Daud Koleosho, 44, of Gilbert, were charged by separate informations with conspiracy to commit health care fraud in connection with an alleged $57 million substance abuse treatment fraud scheme. As alleged in the informations, Mutwol and Koleosho owned Community Hope Wellness Center LLC (“CHWC”), an outpatient treatment center, which was purportedly in the business of providing addiction treatment services for persons suffering from alcohol and drug addiction. CHWC enrolled as a provider with Arizona Medicaid. To obtain and retain patients for CHWC whose insurance could be billed for substance abuse treatment services, Mutwol and Koleosho offered and paid kickbacks and bribes to owners of residences that housed substance abuse treatment patients, in exchange for these residence owners referring patients for treatment to CHWC. Mutwol and Koleosho submitted $57 million of false and fraudulent claims to Arizona Medicaid for treatment services that were not provided, were not provided as billed, were not provided by qualified personnel, were so substandard that they failed to serve a treatment purpose, were not part of any treatment plan, and were medically unnecessary. The case is being prosecuted by Trial Attorney S. Babu Kaza of the Midwest Strike Force, Assistant Chief James Hayes of the National Rapid Response Strike Force, and Assistant U.S. Attorney Matthew Williams of the U.S. Attorney’s Office for the District of Arizona.
A complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
The investigations in Arizona were conducted by the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG); the Federal Bureau of Investigation (FBI); the Department of Veterans Affairs, Office of Inspector General (VA-OIG); and the Defense Criminal Investigative Service (DCIS). The United States Attorney’s Office, District of Arizona, Phoenix, and the Department of Justice’s Criminal Division, Fraud Section, are handling these prosecutions.
CASE NUMBERS: CR-24-01040-PHX-ROS
CR-24-01068-PHX-DWL
CR-24-01075-PHX-MTL
CR-24-01044-PHX-MTL
CR-24-01097-PHX-SPL
CR-24-01098-PHX-MTL
RELEASE NUMBER: 2024-085_ National Health Care Fraud Enforcement Action
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For more information on the U.S. Attorney’s Office, District of Arizona, visit http://www.justice.gov/usao/az/
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