Arizona man sentenced to 3.5 years for defrauding medical practice where he worked

PHOENIX — An Arizona man was sentenced to 3.5 years in prison for defrauding the medical practice where he worked, prosecutors announced.

In addition to the prison time, Jose Andres Lopez was given seven years of supervised release and ordered to pay $45,000 in restitution, according to the Arizona Attorney General’s Office.

Prosecutors added that Lopez previously pleaded guilty to fraudulent schemes and artifices as well as second-degree money laundering.

“My office has one of the best health care fraud and abuse divisions in the country,” Attorney General Kris Mayes said in the Wednesday announcement. “I’m proud of the work they did on this case to uncover the fraud and illegal actions of this medical employee and their relentless effort to ensure Arizona Health Care Cost Containment System (AHCCCS) dollars and other health care spending in Arizona is protected from waste, fraud and abuse.”

How did Lopez defraud the medical practice where he worked?

Lopez was employed at a medical clinic in Mohave County from June 2017 to March 2021.

During his time at the clinic, Lopez was promoted to office manager. The position gave him access to the doctor who owned the clinic’s login information to manage electronic records as well as the prescription system.

According to prosecutors, multiple times in 2020 and 2021, Lopez used his access to order unauthorized prescriptions for himself and another employee.

In addition, between February and December 2020, Lopez reportedly falsified patient visit records for himself to show he was receiving physical therapy from the doctor when he wasn’t.

The fraudulent visit records were then submitted to two insurance carriers for personal injury claims that Lopez made citing a car accident. Due to the fake documents, the insurance companies ended up paying Lopez at least $45,000 in order to settle the personal injury claims.

Prosecutors noted that Lopez was previously sentenced in 2022 by the Maricopa County Superior Court for providing false information to the AHCCCS to obtain healthcare benefits for himself. In that case, Lopez was order to restitution to AHCCCS.

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