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$200k medical fraud funded man's lavish lifestyle

THOMAS Mainey took friends on a lavish trip, chartering a private plane between Rockhampton and Brisbane and rented a multi-bedroom penthouse in Sydney before his sophisticated medical fraud operation was uncovered.

Mainey, 26, yesterday pleaded guilty in the Rockhampton District Court to fraud charges for stealing $203,420 from Medicare and private health funds, along with forging a Rockhampton doctor's signature for 40 prescriptions.

He also used the funds to pay for first class flights to Europe and top-level accommodation for him and his wife in 2015/16, along with spending money on jewellery, cigars, restaurants and electronic goods.

Thomas Henrick Mainey was employed as a practice manager for two specialists, Dr Debora Garcia and Dr Antonio Vega Vega, at the Rockhampton Mater Hospital between May 2014 and January 2016 when he set up a sophisticated fraudulent operation based around a fake business, Cardiac Rhythm Analysis Queensland.

This operation included an ABN number, fraudulently obtaining a Medicare provider number under his employer's name, personalised stationary, paying to attend a specialists' conference in Sydney, an accountant, membership fees for an international cardiology association and medical malpractice civil liability insurance.

Crown prosecutor Tiffany Lawrence said Mainey used Dr Garcia's details to obtain the provider number and then used her and Dr Vega Vega's patient details to make claims to Medicare and private health providers.

The court heard he made 1269 claims using 379 patients' names to Medicare, pocketing $118,972 into his own account; along with 34 patients' details for 38 claims to private health funds amounting to $84,428.

Ms Lawrence said the highest pay out was for $19,688.50 and he received the last pay out two days before his arrest on January 9, 2017 - when he flew back into Rockhampton from his Europe trip.

She said he even went as far as trying to claim some of the Sydney penthouse trip funds as a business trip.

Ms Lawrence said Dr Garcia became suspicious of Mainey's spending after he flew out for Europe and she found reference to the ABN and accountant, along with the personalised stationery on his work computer which was then reported to police.

Mainey was earning $53,000 a year in the role and was paid $31,000 in bonuses.

Ms Lawrence said said Dr Garcia's reputation had been damaged because of Mainey's criminal activities with one patient approaching her in a shopping centre, suggesting she was the person illegally making Medicare/private health fund claims.

"On July 3, 2017, the defendant posted a picture of himself (on Facebook) in shackles," she said.

The post read "How can I afford my millennial smashed avocado lunch without resorting to crime?"

Defence barrister Maree Willey that said this was more in reference to the media hype around millennials not being able to afford to buy a house because of lifestyle choices after Australian millionaire and real estate mogul Tim Gurner made reference to millennials buying smashed avocados in May 2017.

Ms Willey said Mainey started working at the Mater in May 2013, initially in administration, then as a technician and later as practice manager.

She said he was working 16-hour days, 5.5 days a week and his alcohol consumption increased in 2013 and 2014.

Ms Willey said his wife then had a miscarriage in August 2015 and his alcohol consumption increased to three bottles of wine per night plus beer.

Since his arrest, he has lost his wife, job, reputation, house and declared bankruptcy.

He has seen a psychiatrist for 18 months who diagnosed him with major depressive disorder with alcohol dependence.

Judge Brian Devereaux said the degree of dishonesty in this case was appalling.

"It's particularly disturbing you obtained a Medicare provider number in the name of one of your employers," he said.

"It is difficult to see any motivation for your offending apart from greed."

He sentenced Mainey to two years' prison for the health fund fraud and three years for the Medicare fraud to be served cumulatively. Mainey is set to be released from prison on July 15, 2019.

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