Pennsylvania physician pleads guilty to billing fraud

A former Pennsylvania physician will pay more than $400,000 in restitution after pleading guilty to fraudulently billing Medicare and Medicaid. 

The Justice Department alleged that John Keun Sang Lee, MD, 79, of Venetia, submitted claims for steroid injections that were not medically necessary to Medicare and Medicaid at his pain management clinic between May 2016 and October 2020. 

Dr. Lee allegedly required patients to receive steroid injections even when the patients reported the injections were not helping and were causing more pain and other injuries, according to a Nov. 4 Justice Department news release. He also allegedly instructed employees to withhold medication if patients refused an injection. To justify billing insurance companies, Dr. Lee told staff to use templates indicating patients received 80 percent relief from prior pain injections. 

Dr. Lee agreed to pay about $265,000 in restitution to HHS and more than $153,000 to the Pennsylvania Department of Human Services, according to the release. He is scheduled to be sentenced March 7 and faces up to 10 years in prison. 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars