PHOENIX — According to the Arizona Attorney General’s Office, billing through the American Indian Health Plan for behavioral health services through AHCCCS totaled more than $3.1 billion between 2021 and 2023.

Since investigators began aggressively targeting fraudulent sober living homes and treatment providers in 2023, the state says that number has fallen to about $230 million between 2024 and 2026, a 92% decline.

Mayes announced the latest update while discussing the sentencing of nurse practitioner Rita Anagho, who prosecutors say billed Medicaid for services she never provided.

“She was sentenced to 3.5 years in prison,” Mayes said.

The attorney general’s office says Anagho was part of a broader network of fraudulent behavioral health operations that exploited Arizona’s Medicaid system for years, in some cases billing for patients who never received care at all.

“This was a systematic pattern of fraudulent billing,” Mayes said.

The crackdown has become one of the largest fraud investigations in Arizona history. So far, the attorney general’s office says it has brought more than 140 cases tied to the scheme, with roughly 100 still moving through the legal system.

State leaders say the fraud disproportionately impacted Native American communities, with many victims recruited into unlicensed or fraudulent sober living homes across Arizona.

At the same time, some legitimate treatment providers have raised concerns that the state’s aggressive response has slowed reimbursements for real patient care.

Mayes defended the state’s approach, saying officials believed strong enforcement action was necessary because of the scale of the fraud.

“We felt it was necessary to be aggressive due to the amount of fraud that was going on,” Mayes said. “AHCCCS is working every day to ensure legitimate providers are getting reimbursed for the services they do provide.”

The attorney general said additional prosecutions remain possible as investigations continue.