News Summary
Arizona is at the center of a Medicaid fraud scheme involving the indictment of 20 individuals, a mental health business, and a church accused of defrauding $60 million from the state’s Medicaid program. The fraudulent activities included fictitious mental health treatments and financial misconduct, particularly affecting Native American communities. Attorney General Kris Mayes has launched a crackdown, resulting in multiple arrests and calls for accountability within the healthcare system.
Arizona is at the center of a significant legal case following the indictment of 20 individuals, one mental health business, and a church implicated in a major Medicaid fraud scheme that allegedly defrauded the state’s Medicaid program of $60 million. The fraudsters reportedly provided fictitious mental health treatments and addiction rehabilitation services while preying on vulnerable populations, notably within Native American communities.
At the center of the accusations is Happy House Behavioral Health LLC, a company that is alleged to have received Medicaid payments for services that were either never delivered or were only partially completed. Reports suggest that claims were submitted for individuals who were deceased or incarcerated, further complicating the fraud’s scale. Additionally, it is claimed that sober living homes improperly referred clients to Happy House, thus violating Arizona state law.
The investigation has revealed a further layer of financial misdeeds, including money laundering allegations. Happy House reportedly paid $5 million to Hope of Life International Church in July 2023, which subsequently transferred $2 million to an entity in Rwanda. Aside from money laundering, Happy House faces additional charges of conspiracy, fraud, forgery, theft, and more, pointing to a complex network of deceit within the healthcare system.
While Hope of Life International Church has denied any wrongdoing, asserting they were unjustly charged for accepting a donation from a tenant implicated in fraud, the consequences of this fraudulent scheme have been devastating for many. The ongoing crackdown led by Arizona Attorney General Kris Mayes has already seen over 100 individuals and companies charged amidst broader efforts to combat Medicaid fraud within the state. As a direct result of this crackdown, payments have been suspended to more than 100 healthcare providers implicated in the investigations.
The impact of these fraudulent activities is particularly severe for Native American communities, especially the Navajo Nation, where an unknown number of individuals have been left without adequate housing or support services. Accounts have emerged of Native Americans being transported in unmarked vehicles from remote areas of their communities to facilities in the Phoenix area, often under false pretenses of receiving necessary treatment.
Among those also indicted is Daud Koleosho, a nurse practitioner from Gilbert, and his partner, who are linked to a separate health care fraud scheme worth $51.6 million. Their organization, Community Hope Wellness Center, allegedly targeted Native Americans and submitted over $57 million in false claims to Arizona’s Medicaid program. The accusations include offering and paying for kickbacks in exchange for referrals, which significantly inflated the financial benefits accrued from fraudulent claims.
Additionally, the case has drawn in another couple from Gilbert, Thomas and Kanisha Heard, who are being accused of receiving $34.8 million through fraudulent billing practices via their healthcare business. Civil action has been initiated against them, seeking the forfeiture of $1.7 million in cash and luxury possessions, though they have yet to face any criminal charges.
The fraudulent practices have reportedly included the billing of minors for unnecessary treatments, including alcohol abuse therapies for children as young as 2.5 years old. Furthermore, investigations have uncovered extensive acts of “ghost billing,” which involved submitting claims for deceased patients and duplicate charges, underscoring the breadth of deceit that pervaded these operations.
This complex web of alleged healthcare fraud has resulted in significant ramifications, including multiple arrests and a growing call for accountability in healthcare practices, particularly those affecting vulnerable populations, such as Native Americans. As the investigations continue, the state of Arizona finds itself at the epicenter of a nationwide conversation concerning fraud within the healthcare system.
Deeper Dive: News & Info About This Topic
- Gilbert Sun News
- Wikipedia: Healthcare Fraud
- Ahwatukee News
- Google Search: Medicaid fraud Arizona
- AZ Central
- Google Scholar: Arizona healthcare fraud
- Fox 10 Phoenix
- Encyclopedia Britannica: Medicaid
- 12 News
- Google News: Arizona health fraud
