Pa. U.S. Attorney: Former Pain Management Doctor Pleads Guilty to Health Care Fraud

PITTSBURGH, Pennsylvania, Nov. 5 -- The U.S. Attorney for the Western District of Pennsylvania, Cindy Chung, issued the following news release Nov. 4, 2022:

A former physician pleaded guilty today in federal court to a health care fraud charge associated with the pain management practice, Jefferson Pain and Rehabilitation Center, United States Attorney Cindy K. Chung announced today.

Dr. John Keun Sang Lee, age 79, of Venetia, Pennsylvania, pleaded guilty to one count of health care fraud before United States District Judge W. Scott Hardy.

In connection with the guilty plea, the court was advised that between in and around May 2016 to in and around October 2020, Lee knowingly and willfully submitted claims for steroid injections to Medicare and Medicaid that were neither reasonable nor medically necessary. According to former patients and employees, Lee required patients to submit to steroid injections, even when patients reported that the injections were not helping but rather causing them more pain and other 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.

Judge Hardy scheduled sentencing for March 7, 2023, at 9:30 a.m. 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.

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