Arizona couple sentenced to prison in health care fraud

Posted at 9:34 AM, Nov 25, 2016
and last updated 2016-11-25 14:59:50-05

An Arizona couple who live on the Navajo Indian Reservation has been sentenced to prison and ordered to pay millions of dollars in restitution after pleading guilty to health care fraud involving thousands of medical transports that never occurred.

Fort Defiance residents Sylvia Jean Begay and Virgil C. Begay were sentenced to 28 months and 21 months in prison, respectively.

The case is the second involving the Arizona Health Care Cost Containment System and multimillion-dollar frauds to come to light in recent years.

The U.S. Attorney's Office for Arizona said the Begays each owned a company that made thousands of false claims to Arizona's Medicaid program, known as the Arizona Health Care Cost Containment System, for non-emergency medical transports.

The 44-count indictment that charged the couple on Dec. 1, 2015, listed numerous non-emergency transports made on weekends and holidays.

U.S. District Judge Murray Snow sentenced the couple Tuesday in Phoenix on their guilty pleas to one count each of health care fraud.

The restitution orders total $3.5 million.

In May, the program's former chief procurement officer was sentenced to 10 years in prison and ordered to forfeit his state retirement benefits and pay full restitution after earlier pleading guilty in a yearslong fraud scheme involving $5.9 million in fake billings.

Beth Kohler, AHCCCS deputy director, said Friday the investigation into the Begays resulted from a Medicare investigation. She did not elaborate on the other investigation.

"Sometimes it takes a period of time before we can identify ... patterns in the data and then we move swiftly with law enforcement to bring law enforcement to justice," Kohler said.