Vestah Tikium and her sons Terdell and Terrell Dawes received prison sentences for their roles in defrauding Arizona’s Health Care Cost Containment System, Arizona’s Medicaid agency.
Tikium was sentenced to 33 months in federal prison, followed by three years of supervised release. Terdell Dawes, was sentenced to 24 months in federal prison, while Terrell Dawes, was sentenced to 18 months in federal prison. Tikium and her sons also were ordered to pay more than $3 million in restitution. All three had previously pleaded guilty to conspiracy to commit health care fraud. All defendants are members of the Navajo Nation.
Tikium and her sons falsely billed Arizona’s Health Care Cost Containment System (AHCCCS) for tens of thousands of medical transports that never occurred, generating more than $3 million in fraudulent payments from AHCCCS. AHCCCS offers health care programs to low-income Arizona residents. Tikium and her sons owned and operated Diné Transport, which purported to provide non-emergency medical transportation for AHCCCS recipients on the Navajo reservation. Approximately 95% of the claims submitted by Diné Transport between March 2013 and July 2013 were false.
In the last year, five other individuals have been convicted and sentenced for perpetrating similar frauds to falsely bill AHCCCS for non-emergency medical transports that purportedly occurred on the Navajo Reservation:
In November 2016, Sylvia Begay was sentenced to 28 months in federal prison and ordered to pay more than $2.1 million in restitution. Also in November 2016, Virgil Begay was sentenced to 21 months in federal prison and ordered to pay more than $1.3 million in restitution. In March 2017, Natasha Begaye was sentenced to probation and ordered to pay approximately $380,000 in restitution. Also in March 2017, Cortasha Upshaw was sentenced to probation and ordered to pay approximately $245,000 in restitution. In April 2017, Elseddig Musa was sentenced to 57 months in federal prison and ordered to pay more than $1.2 million in restitution.