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Local ophthalmologist indicted on fraud schemes

Posted 1/9/20

Arizona Attorney General Mark Brnovich’s office announced last week that an ophthalmologist and eye surgeon with a clinical office in Fountain Hills has been indicted on multiple counts of …

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Local ophthalmologist indicted on fraud schemes

Posted

Arizona Attorney General Mark Brnovich’s office announced last week that an ophthalmologist and eye surgeon with a clinical office in Fountain Hills has been indicted on multiple counts of fraudulent schemes.

A release from the Attorney General’s Office states that, “Dr. Michael Lee Ham, ophthalmologist and eye surgeon at Kokopelli Eye Institute, has been indicted by a State Grand Jury for charges of conspiracy, fraudulent schemes and artifices, illegal control of an enterprise, theft and money laundering violations for allegedly defrauding Medicare, the United States Department of Veterans’ Affairs and the Arizona Health Care Cost Containment System (AHCCCS), as well as several private health insurers.

“Ham is accused of fraudulently billing the aforementioned institutions for hundreds of thousands of dollars for nearly a decade between 2009 and 2018. Ham was arrested on Jan. 2 in Prescott Valley.”

The release continues that, “Kokopelli Eye Institute maintains eight ophthalmology offices in Arizona serving Prescott, Prescott Valley, Peoria, Wickenburg, Surprise, Kingman, Glendale and Fountain Hills.”

The indictment alleges that between May 13, 2009, and Oct. 10, 2018, Dr. Ham directed 46 current and former subordinate employees to fraudulently complete patient eye examination documents with false information and/or to artificially include deficient exam results in order to meet third-party insurer standards to determine whether disbursement of payments for cataract and laser surgeries are rendered.

The indictment was the result of a multi-agency investigation involving the Special Investigations Section of the Arizona Attorney General’s Office, the U.S. Department of Health and Human Services, Office of Inspector General and AHCCCS.