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Arizona Eye Surgeon Accused Fraud, Falsifying Patient Records For Cataract Surgeries

Written by The Bee

January 5, 2020

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Ham is accused of 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 allegedly billed the victims for hundreds of thousands of dollars for nearly a decade between 2009 and 2018. Ham was arrested on January 2 in Prescott Valley.

According to the Arizona Attorney General’s Office, Kokopelli Eye Institute maintains eight ophthalmology offices in Arizona serving Prescott, Prescott Valley, Peoria, Wickenburg, Surprise, Kingman, Glendale, and Fountain Hills. Between May 13, 2009, and October 10, 2018, Dr. Ham allegedly 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 documents were maintained in patient records to keep a face of legitimacy in the event of oversight of the recommended surgeries and medical procedures, according to the press release.

It appears, the indictment alleges, some of the cataract surgeries were “not medically necessary.”

The criminal case is ongoing.

#TheBee |

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