Arizona Senator Pushes Federal Action on Tribal Medicaid Fraud

Arizona State Senator Carine Werner (R-LD4) is calling for expanded federal action over alleged ongoing Medicaid fraud targeting Native American communities, while Arizona Attorney General Kris Mayes is accusing Werner of politicizing investigations already underway by state and federal authorities.

The dispute escalated this week after Werner announced her office had received new whistleblower evidence alleging continued fraud, patient brokering, and abuse connected to behavioral health providers operating through Arizona’s Medicaid system, the Arizona Health Care Cost Containment System (AHCCCS). Werner said she forwarded the material to the Arizona Attorney General’s Office and sent a formal request to U.S. Attorney Timothy Courchaine seeking federal criminal prosecutions, civil enforcement actions, and asset forfeiture proceedings.

According to a press release issued Wednesday by Arizona Senate Republicans, the allegations involve repeat offenders allegedly continuing to operate on tribal lands through Arizona’s American Indian Health Program (AIHP), which provides Medicaid-funded health coverage to Native American patients. Werner said whistleblowers provided “detailed records and firsthand accounts” regarding alleged abuses within the system.

“Whistleblowers trusted my office because they knew we would act,” Werner said in the release. “Vulnerable Native American patients are being exploited right now while taxpayers foot the bill for massive fraud. The excuses and delays must end.”

The allegations are the latest development in Arizona’s multi-year sober living home and behavioral health fraud scandal, which has centered heavily on Native American patients enrolled in AIHP. Investigative reporting by the Arizona Center for Investigative Reporting found that fraudulent providers recruited Indigenous patients with promises of housing, transportation, addiction treatment, and recovery services before billing AHCCCS for services allegedly never provided.

ProPublica and AZCIR reported in 2025 that at least 40 Native Americans died in Phoenix-area sober living homes and treatment facilities between 2022 and 2024 while state agencies struggled to contain the fraud.

Arizona Attorney General Kris Mayes addressed the issue extensively during a Thursday press conference announcing additional Medicaid fraud enforcement actions. During the event, Mayes stated her office has now secured 140 indictments and 41 convictions connected to Medicaid fraud investigations since 2023. 

Mayes also announced the sentencing of Rita Anago, a nurse practitioner connected to TUSA Integrated Clinic, who prosecutors accused of billing Medicaid for services allegedly provided to children, incarcerated individuals, and deceased patients while targeting Native American beneficiaries. According to Mayes, Anago was sentenced in state court to 3.5 years in prison after previously being ordered to pay $55 million in restitution in a separate federal case. 

During the conference, Mayes disclosed new figures regarding the scale of alleged fraud within AIHP behavioral health billing.

According to Mayes, behavioral health billing within Arizona’s American Indian Health Plan totaled approximately $3.1 billion between 2021 and 2023 before falling to roughly $230 million following enforcement actions initiated by the Attorney General’s Office and AHCCCS beginning in 2023. 

Mayes stated the decline represented a 92 percent reduction and argued the figures demonstrated that “nearly all” of the billing increases during that period were attributable to fraud. 

“This fraud metastasized for years until we exposed it,” Mayes said during the press conference. 

Mayes repeatedly blamed prior state leadership for failing to stop the fraud earlier, specifically criticizing the administration of former Governor Doug Ducey and accusing previous officials of not responding aggressively enough as billing levels surged between 2021 and 2023. 

The Attorney General also sharply criticized Werner directly during the press conference after reporters asked about the senator’s new allegations.

In the Senate press release, Werner’s office stated, “These latest allegations mirror the systemic failures uncovered in five Senate Health & Human Services Committee hearings since July 2025 that examined over $2.8 billion in behavioral health fraud through Arizona’s Medicaid system. Despite prior enforcement actions, Attorney General Kris Mayes failed to secure the aggressive prosecutions and asset seizures necessary to stop these repeat offenders from the beginning.”

According to Mayes, Werner contacted the Attorney General’s Office last week to request an urgent meeting regarding potential evidence of Medicaid fraud. Mayes said members of the Medicaid Fraud Control Unit met with Werner on May 11 and subsequently confirmed with the FBI that federal authorities already had an open investigation involving the individuals and entities identified in the whistleblower materials. 

“My team thanked her, took the information, and immediately checked with the FBI,” Mayes said. “They already had an open investigation into the individuals and entities Ms. Werner had received the tip on.” 

Mayes accused Werner of turning the issue into what she described as “a bullshit political attack.” 

Werner and Senate Republicans have argued that state agencies still are not acting aggressively enough against repeat offenders exploiting Native American communities through AIHP-funded behavioral health programs. Werner has also sponsored legislation aimed at restructuring portions of AHCCCS oversight, increasing anti-fraud enforcement tools, and tightening oversight of behavioral health billing practices.

Native News Online reported earlier this year that Werner introduced a seven-bill reform package focused on fraud prevention, patient protections, reimbursement oversight, and behavioral health access for Native American communities.

“Patients are dying while the same fraud networks simply reorganize under new names and continue targeting tribal communities,” Senator Werner said in a statement. “My office will keep pushing for prosecutions, asset seizures, and real reforms.”

Werner stated her office plans to hold a press conference on May 18 to discuss the latest allegations and proposed reforms.