Medical employee sentenced to prison for insurance fraud, impersonating doctor

MOHAVE COUNTY, Ariz. — A former medical clinic employee will serve 3.5 years in prison followed by seven years of supervised probation for defrauding insurance companies and impersonating a doctor, Arizona Attorney General Kris Mayes announced today.

Jose Andres Lopez pleaded guilty to fraudulent schemes and money laundering charges after creating false patient records and submitting unauthorized insurance claims totaling at least $45,000, according to the attorney general's office. Lopez worked as office manager at a Mohave County medical clinic from June 2017 through March 2021.

Between February and December 2020, Lopez created fake patient visit records showing he received physical therapy treatment from the clinic's doctor, the attorney general's office says. Lopez used these false records to support a personal injury claim from an automobile accident, resulting in insurance payouts of at least $45,000.

"My office has one of the best Health Care Fraud and Abuse divisions in the country," Mayes said in announcing the sentence.

Lopez also used his access to the doctor's electronic records system to send unauthorized prescriptions for himself and another employee on multiple occasions in 2020 and 2021, prosecutors say. In a separate case, Lopez provided false income information to Arizona's Medicaid program to obtain healthcare benefits.

The Mohave County Superior Court sentenced Lopez on Sept. 22 following an investigation by the attorney general's Health Care Fraud and Abuse Section.