from the Superior Court in Maricopa County No.
CR2015-000299-001 The Honorable Michael W. Kemp, Judge The
Honorable Pamela S. Gates, Judge
Arizona Attorney General's Office, Phoenix By Michael T.
O'Toole Counsel for Appellee
Maricopa County Public Defender's Office, Phoenix By
Mikel Steinfeld Counsel for Appellant
Diane M. Johnsen delivered the opinion of the Court, in which
Presiding Judge Lawrence F. Winthrop and Judge Maria Elena
Chalice Zeitner was convicted of defrauding the Arizona
Health Care Cost Containment System (" AHCCCS") by
lying to a physician to obtain coverage for an abortion. On
appeal, she argues the superior court breached the
physician-patient privilege by admitting her medical records
and allowing her physicians to testify against her. We hold
the privilege is abrogated by statute in cases of suspected
AHCCCS fraud and affirm Zeitner's convictions.
AND PROCEDURAL BACKGROUND
Zeitner went to a Phoenix obstetrician for an abortion in
March 2010. She told him she just had discovered she was
pregnant after recently undergoing extensive radiation and
chemotherapy treatments for cancer. Zeitner said she wanted
an abortion because she thought the radiation and
chemotherapy likely had harmed her fetus. After examining
Zeitner, however, the obstetrician concluded she was
well-nourished and healthy, about 20 weeks' pregnant and
in no acute distress. Accordingly, he proposed a course of
care designed to avoid an abortion. He told Zeitner to obtain
information from her cancer physicians about her treatments
and referred her to a specialist in high-risk pregnancies in
the hope that she could deliver a viable baby.
Zeitner met with the specialist a few days later. Examining
Zeitner, the specialist grew suspicious. He thought it
unusual that, although Zeitner told him she had a diagnosed
malignant uterine tumor, the physicians treating her cancer
had not removed her uterus. Zeitner told the specialist her
main chemotherapy drug was acetaminophen-an over-the-counter
pain reliever, not a chemotherapy drug. And Zeitner was
unable to relate details of her cancer diagnosis or
treatment, other than that she had been diagnosed at a
hospital in Boston. From an ultrasound, the specialist saw no
abnormalities that compelled an abortion. He reported his
concerns about Zeitner's veracity to the obstetrician.
A few days later, Zeitner successfully applied for AHCCCS
benefits. AHCCCS had turned down an application
Zeitner had submitted just a month before, citing
insufficient documentation. Although Zeitner's earlier
application had said she had no serious or chronic illnesses,
on the application she submitted in late March, Zeitner
stated she had a serious chronic illness and said her
pregnancy was high-risk and life-threatening.
On March 31, the obstetrician received an email signed
"Al Zeitner" that seemed to be following up on
behalf of Chalice Zeitner. Referencing Chalice in the third
person, the email stated the author was waiting to hear back
from the obstetrician about a "procedure" that he
purportedly had proposed. The email suggested the procedure
was urgent, stating:
Chalice is scheduled to resume chemo and radiotherapy on
April 9th. She must have the tumors removed in the next 4
weeks. She is on bedrest and supervised care in her home
until notice from [the Phoenix obstetrician] of this
Shortly thereafter, Zeitner brought the obstetrician a letter
dated April 1, purportedly written by a "Dr.
McMahon" at the Boston hospital Zeitner claimed had
treated her for cancer. The letter recommended that Zeitner
"receive an urgent [abortion] . . . to relieve third
term life-threatening certainties to the patient."
Attached to the letter was a list of chemotherapy and
radiotherapy medications purportedly prescribed to Zeitner.
(Although a physician named McMahon actually practiced at the
Boston hospital at the time, he had never treated Zeitner and
had not written the letter or created the list of medications
Zeitner gave to him.)
Accepting the letter as authentic, the obstetrician concluded
Zeitner urgently needed an abortion. Based on his opinion
that an abortion was necessary to protect Zeitner's
health, AHCCCS authorized payment, and the obstetrician
aborted Zeitner's fetus on April 9.
Meanwhile, Zeitner launched a scheme to garner donations from
friends and others to fund her purported cancer treatments.
Using the name "Trinity McLaughlin, " Zeitner sent
a social media message to her boyfriend, informing him that
"Trinity" and a few others had created a webpage to
raise funds for Zeitner's cancer treatments and
suggesting the boyfriend take over the fundraising effort.
The next week, "Trinity" emailed the boyfriend
fundraising materials for him to use, including a
heartrending plea for donations detailing Zeitner's
cancer, her costly painful treatments and her resulting
Acting on "Trinity's" request, the boyfriend
posted on a fundraising website the story "Trinity"
had sent him, forwarded "Dr. McMahon's" letter
to the website to satisfy its request for proof that Zeitner
actually had a medical condition, opened a bank account for
donations, and solicited more than 600 social media friends
to help pay for the purported cancer treatments. In response,
more than 20 people donated a cumulative total of more than
$2, 000 to Zeitner's cancer fund via the website.
Several months later, Zeitner became pregnant again, and the
Phoenix obstetrician delivered her child by caesarean
section. During the procedure, the obstetrician saw no
evidence that tumors had been removed from Zeitner's
uterus or that she had undergone chemotherapy or radiation.
By then highly suspicious about Zeitner's claimed cancer,
the obstetrician contacted Dr. McMahon at the Boston
hospital, who said he had not treated Zeitner nor authored
the letter ...