Rehab Scam Affects Native Clients

PHOENIX - Autumn Nelson revealed she had sought treatment for her alcohol dependency last spring. It was her peers from the Blackfeet Nation in Montana who pointed her towards a rehab facility in Phoenix, considerably further south.

Nelson, aged 38, mentioned that the institution even procured a one-way flight for her to undertake the long 1,300-mile trip. However, after just a month, she was evicted. She voiced her reservations about the glaring disparity: “All of a sudden I was out in the 108-degree heat in Phoenix, Arizona,” Nelson described. “I was scared, and didn’t know where to go.”

Now resettled in the Blackfeet reservation, Nelson stands with countless other Native Americans who have become victims of deceptive practices in the Phoenix region. As per authorities, such malicious activities have frequently rendered clients without homes and, in some scenarios, have filled the pockets of the deceitful operators with luxuries. In the past few years, these rackets have cost Arizona a fortune, running into hundreds of millions, as estimated by state officials.

The majority of these illicit billings were routed through the American Indian Health Program. This Medicaid health plan facilitates providers to directly charge for services rendered, specifically to Native Americans and Alaska Natives.

Federal law permits Native Americans registered in federally recognized tribes to opt for either the fee-for-service plan or a managed care plan. The state Medicaid scheme, named AHCCCS — Arizona Health Care Cost Containment System — collaborates with managed care entities to offer health services to the majority of Medicaid participants in Arizona. Simultaneously, the fee-for-service scheme enables Native Americans to consult any provider affiliated with AHCCCS.

The ripple effects of these scams are emerging, with alerts being raised by state and tribal administrations beyond Arizona, including by Montana’s U.S. Sen. Jon Tester, a Democrat, and Gov. Greg Gianforte, a Republican.

In May, Arizona’s Governor, Katie Hobbs, and Attorney General Kris Mayes took action. Mayes has expressed that they suspect a Nevada-rooted criminal group initiated these scams. They intensified an existing inquiry into deceptive Medicaid billing that commenced before their official tenure in January. Both the FBI and the U.S. Attorney General’s Office are collaborating with Arizona’s legal officials on this investigation. Furthermore, Tester has urged the Centers for Medicare and Medicaid to initiate their own inquiry.

Arizona State Sen. Theresa Hatathlie, a Democrat, Navajo, and resident of the reservation, stated that non-medical transport firms, which allegedly transported Native Americans from their reservations to sham programs, must also face scrutiny. Adding to this, the New Mexico Attorney General initiated the “Don’t be taken for a Ride” campaign, cautioning individuals against accepting rides from unfamiliar individuals to rehabilitation facilities in Arizona.

Both the Navajo Nation and the Blackfeet Nation have proclaimed public health crises to allocate resources to assist impacted community members. Additionally, the Navajo Nation introduced a scheme termed Operation Rainbow Bridge, aiming to guide members either to authentic programs or to safely return them to their reservation.

The Blackfeet tribe’s leadership has determined that any of their members caught recruiting on the reservation for fraudulent programs could face hefty fines and even potential expulsion.

The state of Arizona has halted Medicaid payments to the facility where Nelson resided — the contact number listed on the center’s LinkedIn profile is now defunct — and has also suspended over 300 other providers due to “credible allegations of fraud” as recorded on Aug. 18. While some of these providers have shut down, others have lodged appeals to remain operational.

In response to the scams, AHCCCS has implemented stricter measures. This includes a six-month freeze on registering new behavioral health clinics for Medicaid invoicing. Additionally, onsite inspections and comprehensive background screenings, inclusive of fingerprint checks, have become mandatory for behavioral health providers categorized as high-risk during their enrollment or revalidation process.

The prevalence of these scams surged amidst the COVID-19 lockdowns.

Dr. John Molina, the health service director for the federally sponsored Native Health, which caters to Native Americans in Phoenix, commented, “There were a lot of rules relaxed that allowed those scammers to get in.” He emphasized that addiction issues within the Native American community can be traced back to multi-generational trauma.

Molina, with roots in the Pascua Yaqui and San Carlos Apache communities, remarked, “This takes us back to the early years of colonization and how Natives were taken advantage of for economic gain.”

In the previous year, Johnwick Nathan, 29, faced indictment on several charges encompassing fraud, money laundering, and forgery. It’s alleged by officials that Nathan unlawfully invoiced Medicaid representing Native American clients, an accusation he refutes. His trial is set for Sept. 18.

The profits from such scams can be substantial. A federal case revealed that a woman, who managed a fraudulent recovery program in Mesa, Arizona, confessed in July to wire fraud and money laundering. She had amassed more than $22 million in Medicaid funds during 2020 and 2021 for services that were never rendered.

The court documents don’t specify the ethnicity of the patients. They only indicate that patients were brought to the facility once, after which invoices were made under their names for up to 90 days. Billing was even done for deceased individuals and incarcerated persons.

After a probe led by the Internal Revenue Service, Diana Marie Moore, 42, awaits her sentencing on Dec. 18. As a result of the court’s judgment, she has been mandated to relinquish assets acquired through her deceitful activities. This includes four residences, seven premium vehicles, and a collection of luxury possessions like Rolex timepieces, diamond-studded rings, and an assortment of Louis Vuitton bags.

While visiting Phoenix over the past few months, Navajo police have come across numerous Native Americans stranded on the streets as a result of center closures, Harland Cleveland, the special operations manager for Rainbow Bridge, reported. Many of these individuals are intoxicated and lack mobile phones to contact their relatives, he noted.

Hatathlie mentioned that former patients of these clinics “are too scared” to provide testimonies before the state Senate.

In Phoenix, Reva Stewart and a group of Native American women have initiated an online network aimed at locating missing individuals they refer to as “our relatives.” They share information about the missing on social media platforms.

Stewart, of Navajo descent, became involved after she witnessed vans stopping outside the Phoenix Indian Medical Center, offering individuals a place to stay. “Something didn’t look right,” Stewart remarked, who oversees a nearby Native American arts store. Coincidentally, her cousin vanished into a similar van in New Mexico around the same time.

Following a lengthy journey, her cousin was dismissed from the Phoenix facility she was brought to when she declined to fill out intake forms, according to Stewart. She added that her cousin has since returned to the reservation and is living soberly.

However, not all stories have such resolutions.

Raquel Moody, of Hopi and Apache lineage, recounted her experience in a residence where alcohol consumption was permitted. After a dispute with her cousin Carlo Jake Walker, who persisted in his drinking habits, Moody departed in December. Later, she discovered that Walker succumbed to alcohol overdose and was laid to rest in an indigent grave. Moody, now abstaining from alcohol, volunteers for Stewart’s initiative, #stolenpeoplestolenbenefits, which aids Native American families in locating their kin who were taken to rehab facilities.

Finding addiction recovery solutions on reservations is difficult due to the often limited availability of resources for inpatient treatment.

In 2021, nearly half of the 25,000 arrests on the Navajo Nation were related to public drunkenness, even though the sale of alcohol is forbidden on tribal lands by federal law.

The Blackfeet reservation’s modest residential addiction treatment facility is typically at capacity.

Laura McGee, a Blackfeet member, recounted the distressing disappearance of her brother shortly after he checked into a Phoenix center during spring. After an exhaustive search, the family was able to locate him and return him to Montana. Subsequent to this, Arizona suspended Medicaid reimbursements to the care provider, pending a criminal investigation.

Presently, McGee collaborates with Stewart to support other families in their quests to find missing relatives. In her online endeavors, she recently interacted with Nelson, who expressed a hopeful outlook on her sobriety journey.

Reflecting on her prior experiences, Nelson commented, “That earlier situation traumatized me,” but she added, “But now it has encouraged me to stand up.”