A family member who alleges that she was sexually abused for years by a prominent Maine dermatologist testified Wednesday that she created fake medical invoices – at the doctor’s insistence and occasionally with his help – for hundreds of thousands of dollars to cover up years of financial payments he made to her.

During the second day in the fraud trial of Dr. Joel Sabean in U.S. District Court in Portland, federal prosecutors showed jurors fake hospital invoices that the woman said she created herself, using hospital logos and letterheads she found on the internet and a common computer program to prepare the invoices. One fake bill was from a Boca Raton, Florida, medical center for $202,000 and another was from a different Florida hospital for more than $120,000.

The family member said Sabean asked for the invoices because his wife and co-workers were suspicious about the thousands of dollars he sent the relative, who lived in Florida at the time. The woman said Sabean provided some of the medical codes she used in the false invoices and she then emailed the fake bills to Sabean to submit to his accountant to justify the payments.

Sabean, 69, who lives in Falmouth and has had a successful dermatology practice in South Portland for nearly 40 years, is charged with evading nearly $900,000 in income taxes by claiming more than $2.3 million in improper medical deductions that prosecutors say were actually payments made to the woman over five years. He also is accused of making out dozens of prescriptions for the family member, mostly for anti-depressants and sleeping pills, which is a violation of laws on distributing controlled substances because the relative was not a patient of Sabean’s.

He’s also charged with health care fraud for allegedly prescribing pills for his wife that were actually picked up by the family member. An insurance company covered most of the cost of the medications because Sabean’s wife is on his health care policy, but the relative is not.

The family member, who is now 41, said the sexual abuse by Sabean started when she was 12 or 13 years old. Sabean has not been charged with sexual assault, and prosecutor David B. Joyce declined to say Wednesday why he has not been charged. Sexual abuse of a minor by a relative has a statute of limitations in Maine of six years, but there is no statute of limitations on some sex crimes, including rape.

The Portland Press Herald is not identifying the family member because she is allegedly the victim of sexual abuse.

The woman said Wednesday that the last time she had sex with Sabean was in 2005, in a car near the Sable Oaks Golf Course in South Portland. But she said the two have emailed and phoned each other regularly in the years since, with most of the emails involving sexually explicit tales revolving around “Nurse Mary,” a character the woman said she made up to titillate Sabean. She said she set up a separate email account to correspond with Sabean.

The woman said Sabean knew that she was posing as “Nurse Mary” and encouraged the explicit emails, but Sabean’s lawyers, during their cross-examination of the relative Wednesday afternoon, suggested that he was unaware the character was made up. They said he had purchased an engagement ring for “Nurse Mary” and sent a picture of the ring to the relative to show it off.

Defense attorneys also said Sabean thought the relative’s illnesses were real and her health care bills authentic, and that he was trying to help her with the payments.

The allegation of sexual abuse, defense attorney Thimi Mina said, first arose in the late 1990s when the woman faced legal troubles over a fake check, about eight years after she alleges the abuse started.

“It came to light when you needed an excuse,” Mina told the woman.

The defense is trying to chip away at the woman’s credibility. She admitted Tuesday, shortly after taking the witness stand, that “I’ve had a problem with lying my whole life.” The woman has appeared in court in a prison jumpsuit both days because she has been jailed in Florida since March for violating probation on a shoplifting charge.

Prosecutors said the woman helped Sabean in his effort to lower his taxes and cover up the payments with all the fake medical bills. They said Sabean was trying to avoid paying a gift tax on the payments while sending huge sums to the woman via Western Union, wire transfers, prepaid debit cards, PayPal and deposits into joint banking accounts.

When accountants and bookkeepers started asking questions, prosecutors said, he told them the woman had a range of cascading health problems, such as a drug-resistant infection, gall and kidney stones, toe amputations and reattachements, and even a kidney transplant, all in 2008. In one case, the woman testified Wednesday, she made up an invoice for a heart transplant and Sabean suggested charges for the drugs that a transplant recipient would need to include on the fake hospital bills.

The woman said she spent the money Sabean sent her on drugs, clothes and gambling at casinos. In many cases, that amounted to thousands of dollars a day.

Mina said the woman has been lying for years to get money from Sabean. At one point, he said, she created a fake company, with a fake lawyer handling the fake incorporation, through which she claimed to own a handful of retail shops. In another case, she claimed to be making money through buying and selling antique watches and collectibles, and sought money from Sabean to keep the enterprise going.

The woman said the payments were a combination of hush money and familial doting.

“He wanted to keep me happy,” she testified, adding that he also wanted to keep the explicit emails coming, implying that he would cut off the money if they stopped.

The trial resumes Thursday, with the woman continuing to be cross-examined by defense lawyers. The trial is expected to run through mid-November.