Arizona agency names 44 others tied to alleged exam, billing fraud

Posted 1/15/20

The Arizona Attorney General's Office has released the names of 44 other people tied to alleged fraud involving false eye exams and billing documents.

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Arizona agency names 44 others tied to alleged exam, billing fraud

Posted

The Arizona Attorney General's Office has released the names of 44 other people tied to alleged fraud involving false eye exams and billing documents.

The agency said 44 more summonses have been served on current or former employees of Kokopelli Eye Institute in the case against Dr. Michael Lee Ham, an eye surgeon at the Prescott Valley-based company who was recently indicted for an alleged fraudulent billing scheme.

According to a release, agents with the Arizona Attorney General’s Office and with the U.S. Department of Health and Human Services have been locating and serving indicted defendants. Many are charged with conspiracy and with fraudulent schemes and artifices, while others also face charges of illegally conducting an enterprise, participating in a criminal syndicate and theft.

The indictment alleges the additional defendants helped Dr. Ham in a variety of ways to falsify patients’ medical records for the purpose of inducing government agencies and third-party insurers to pay for cataract and other eye surgeries on patients of Kokopelli from 2009 through Fall 2018. Officials believe it is possible that some patients had cataract surgeries that were not medically necessary.

Officials said longtime employee Laura Lynn Crain is also charged with facilitation to commit fraudulent schemes and artifices, and with criminal impersonation for her alleged participation in illegally obtaining a prescription-only drug at the direction of Dr. Ham. The indictment alleges that Ms. Crain, in conjunction with Dr. Ham, obtained medication from a pharmacy in Prescott Valley in August and November of 2016 under the name of a person who did not consent to, nor was aware of, a prescription being written in her name.

Ms. Crain has been at Kokopelli since 2001, according to her LinkedIn profile.

Dr. Ham was arrested Jan. 2 in Prescott Valley. He was arraigned Monday, Jan. 13 in Yavapai County Superior Court. He faces a slew of charges 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.

In a Jan. 6 email from Kokopelli, medical staff — including Dr. Ham — were available that day to assist patients.

"Dr. Ham intends to vigorously oppose the charges and despite not needing to prove innocence, will show in court that all medical procedures were appropriate and correctly billed," the official stated.

Oddly enough, the official referred further questions to Laura Crain, who is named in the indictment.

Kokopelli has locations in Prescott Valley, Prescott, Kingman, Peoria, Surprise, Wickenburg, Glendale and Fountain Hills.

The investigation and prosecution of this case arose from a report to the Prescott office of the Health Care Fraud & Abuse Section of the Attorney General’s Office. 

The other defendants have been named in an indictment that previously redacted their names. They have not been arrested.

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