Attorney General Mark Brnovich said an ophthalmologist and eye surgeon with offices in Glendale and Peoria has been fraudulently billing for years.
And the eye doctor may have done “surgeries not medically necessary,” according to Brnovich.
Dr. Michael Lee Ham, ophthalmologist and eye surgeon at Kokopelli Eye Institute, has been indicted for charges of conspiracy, fraudulent schemes, theft and money laundering violations for allegedly defrauding Medicare, the United States Department of Veterans’ Affairs, the Arizona Health Care Cost Containment System (AHCCCS) and private health insurers for hundreds of thousands of dollars.
Ham was arrested Jan. 2, in Prescott Valley.
Kokopelli Eye Institute has offices in Glendale, Peoria, Prescott, Prescott Valley, Wickenburg, Surprise, Kingman and Fountain Hills.
According to Brnovich, from 2009 to 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 result.
“The false information was calibrated in such fashion to satisfy the standards of third-party insurers, public and private, for cataract or laser surgery coverage.”
Fraudulent exam documents were maintained in patient records in the event of scrutiny or prospective audits, Brnovich said.
“It is possible some patients had cataract surgeries that were not medically necessary,” the attorney general added.
The indictment follows a multi-agency investigation conducted by 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.
Those with information regarding Ham’s practices are asked to contact AZ AGO Special Agent Mark McClain, Special Investigation Section of the Health Care Fraud and Abuse Unit at 928-778-7463.