Indictments Issued In Case Of Medicaid Fraud

An Arizona grand jury has indicted three people for Medicaid fraud following an investigation by the state attorney general’s office into a charity offering help to Native Americans with substance abuse problems. The US Department of Health and Human Services and the Arizona Health Care Cost Containment System conducted a probe into the “A Better You” Wellness Center in Phoenix after government records revealed it had billed the American Indian Health Program for more than $115 million, some of which state authorities claim was fraudulent.

In May, Attorney General Kris Mayes and Governor Katie Hobbs announced a crackdown on Medicaid billing fraud, which they said had stolen millions of dollars of taxpayers’ money in the Grand Canyon State. Hobbs said unscrupulous groups targeted tribal communities to commit fraud worth hundreds of millions of dollars. Previous investigations by the FBI and the state’s attorney’s office recouped $75 million and led to 45 criminal indictments.

In the latest case, prosecutors allege the fraudulent charges were submitted through the American Indian Health Program, a health specifically for Native populations in Arizona and Alaska.

Earlier this year, the US Department of Health and Human Services’ criminal investigative unit report stated that taxpayers are losing $100 billion annually to Medicaid fraud. Special agent Omar Pérez Aybar said this figure was a conservative estimate. “When we think about all lines of business in Medicare and Medicaid, that’s probably a drop in the bucket,” he claimed.

An unnamed felon who ran an illegal pill-selling business told reporters in March that defrauding the healthcare system is “very easy,” and until he was caught, he lived a lavish life on the proceeds. “I had everything. I had houses, I had cars, I had watches,” he said.

The scheme involved patients obtaining legitimate prescriptions and Medicaid-funded drugs, which he would then sell to medicine wholesalers to sell on again. The same pills were sold and resold multiple times, he explained.

An associate eventually turned him in, and he spent three years in prison.