Dr. John Keun Sang Lee, Health Care Fraud, Pennsylvania 2023

Dr. John Keun Sang Lee, a former pain management doctor, has pleaded guilty to a health care fraud charge in federal court in Pittsburgh, Pennsylvania.

The 79-year-old Lee, of Venetia, Pennsylvania, pleaded guilty to one count of health care fraud, which involved submitting claims for steroid injections to Medicare and Medicaid that were neither reasonable nor medically necessary.

Between May 2016 and October 2020, Lee knowingly and willfully submitted false claims for steroid injections, which were not medically necessary, to Medicare and Medicaid. Former patients and employees reported that Lee required patients to undergo steroid injections, even when they reported that the injections were causing more pain and injuries.

Lee also instructed employees to withhold patient medication if patients objected to the injections. In order to justify billing insurance companies for the medically unnecessary injections, Lee directed staff to use templates indicating that patients received 80% relief from prior pain injections.

The law provides for a maximum sentence of 10 years in prison, a fine of $250,000.00, or both. Under the Federal Sentencing Guidelines, the actual sentence imposed is based upon the seriousness of the offense and the prior criminal history, if any, of the defendant.

As part of his plea agreement, Lee has agreed to pay $264,730 in restitution to the United States Department of Health & Human Services and $153,230 to the Pennsylvania Department of Human Services for losses associated with the fraudulent billings. Lee also has agreed to voluntarily surrender his medical license and DEA registration and not to maintain any ownership or management interest in any medical clinic or facility.

Assistant United States Attorney Karen Gal-Or is prosecuting this case on behalf of the government. The Federal Bureau of Investigation, the Department of Health & Human Services, and the Drug Enforcement Administration conducted the investigation leading to the Indictment in this case.

Dr. Lee pleaded guilty before United States District Judge W. Scott Hardy. Judge Hardy scheduled sentencing for March 7, 2023, at 9:30 a.m.

Source: https://www.justice.gov/usao-wdpa/pr/former-pain-management-doctor-pleads-guilty-health-care-fraud