Diana Moore Sentenced to 66 Months in Prison for Exploiting Arizona’s Medicaid Program

Recently, Diana Moore, a 44-year-old woman from Mesa, Arizona, was sentenced to 66 months in prison for exploiting Arizona’s Medicaid program. This comes after a judge ordered her to pay over $21 million in restitution to the Arizona Health Care Cost Containment System for fraudulently billing the public service.

Moore owned multiple behavioral health counseling services that would submit claims for reimbursements from AHCCCS for services she claimed to have provided to AHCCCS members. However, it was revealed that starting in 2020, Moore began obtaining the identification numbers of AHCCCS members by paying other providers to transport members to her counseling facilities. After the members had left, Moore would continuously bill AHCCCS by falsely claiming that her entities were providing these members with daily care for up to 90 days. She even submitted claims for AHCCCS members who were deceased or imprisoned at the time she claimed to have provided them care.

It was discovered that nearly all of the AHCCCS members billed for by Moore were enrolled in the American Indian Health Plan, which services Arizona’s Native American populations. This scheme was reflective of a larger issue that has been exploiting AHCCCS and Native American patients for the last few years. Indigenous residents are recruited to undergo treatment at illegitimate facilities in Phoenix and then end up stranded without a way to get home.

This type of fraud has cost Arizona over $2 billion, leading to the suspension of AHCCCS payments to over 100 providers in 2023. Moore’s sentencing hearing highlighted the specific harm done to the Native American populations in Arizona as a result of her fraudulent activities.

U.S. Attorney Gary Restaino noted, “Defendant 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.”

Aside from the restitution she owes AHCCCS, Moore was also ordered to forfeit four homes, seven luxury cars, and 100 other items purchased with funds from the fraud scheme.

These incidents shed light on the need for stricter regulations and oversight in healthcare systems to prevent such exploitation and protect vulnerable populations.

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