In the latest example, on December 17, 2024, Mesa’s Britney Gooch and Eric Riley pled guilty to ripping off Arizona’s Health Care Cost Containment System—which, admittedly, hasn’t been doing a very good job of “containing” health care costs—by falsely billing for $3.3 million worth of services they never delivered.
But that’s chicken feed. Sure, Gooch and Riley could receive 10 years in prison and a fine of up to $250,000 for their part in the fraudulent scheme, but it’s nothing compared to the enormity of fraud battering the taxpayers and indigenous people of the Grand Canyon State.
Namely, Arizona Medicaid is in the middle of a massive phony billing scandal—to the tune of an estimated $2.8 billion.
And, as usual, leading the pack of merry thieves cheerfully ripping off taxpayers are the psychiatrists, psychologists, counselors and “behavioral health providers” organizing and operating centers like Gooch and Riley’s.
Moore also submitted claims for patients who were in prison or dead at the time.
The pair, for their part, ran the New Horizons Behavioral Health center in Mesa, which is now listed as “permanently closed” online.
But there were many others, equally guilty.
Beyond every Arizona taxpayer, who were the primary victims? Native Americans—Hopi and Navajo—whom Riley and Gooch pretended were receiving their “mental health services.” Other “behavioral health centers” and “sober homes” likewise treated Arizona’s native population like a cash crop, rather than individuals in need of help.
In August, another Mesa scam artist, Diana Moore, 44, was ordered to pay a $21 million fine, surrender four homes and seven luxury cars, and was sentenced to 66 months in prison for her part in ripping off taxpayers and indigenous people.
Prosecutors say Moore owned several “behavioral health counseling centers,” to which she would pay to have “patients” delivered. Once Moore learned her targets’ names and identifying information, they would be sent away, at which point she would bill Arizona’s Health Care Cost Containment System (AHCCCS) for 90 days of treatment that were never delivered.
Moore also submitted claims for patients who were in prison or dead at the time.
Do you have to be a fraudster to run a “behavioral health center”? Probably not, but it certainly helps!
“The American Indian Health Plan exists to help an underserved community surmount barriers to treatment,” US Attorney Gary Restaino said. “[Moore] misused this program and the unique identification numbers generated by it to benefit herself—in some cases by billing for patients she never treated and in other cases by falsely inflating the duration of treatment.”
Some mental health providers in Arizona have been accused of billing for more hours than they’re open, of double billing, or of billing for patients who were actually in another hospital at the time of “treatment.”
“There has to be an end to this.”
Homeless, addicted or alcoholic Navajo or Hopi have been picked up and driven to “behavioral health centers” where they were pressed into signing up for AHCCCS benefits to pay for nonexistent treatment. Indigenous populations also reported being picked up and taken to “treatment centers” in Phoenix, where they were eventually tossed out with no way to return home.
A December class action lawsuit filed against the state alleged it ignored whistleblower warnings that Arizona taxpayers were being ripped off. When asked for comment, the state agencies replied they were aware of the “pain and suffering associated with behavioral health fraud and the significant impact on Tribal nations in Arizona.”
The situation became so severe that the AHCCCS was forced to suspend payments to over 250 behavioral health providers in the state, prompting yet another crisis: Cut off from billing, sober homes threw patients out into the streets, causing the Navajo Nation to declare a state of emergency.
“There are significant concerns about the impacts to Navajo Nation lives from abrupt displacement that have affected an estimated 5,000 to 8,000 Navajo individuals,” a statement from the Nation read.
Navajo police made contact with 270 indigenous people living on the streets in Phoenix after being ejected from sober homes.
AHCCCS director Carmen Heredia said: “There has to be an end to this.”
You think?
By far, psychiatrists, psychologists, mental health counselors and operators of “behavioral health centers” and “sober homes” are among the leading scam artists ripping off Medicare and Medicaid funding for fake “treatment.”
“A study of US Medicaid and Medicare insurance fraud … over a 20-year period showed psychiatry to have the worst track record of all medical disciplines,” the Citizens Commission on Human Rights wrote in a report.
You have to wonder if they actually teach fraud techniques in “shrink school” these days.
