A doctor indicted for healthcare fraud involving Serostim hormone for HIV patients
A doctor accused of conspiracy to commit healthcare fraud, several counts of committing healthcare fraud, and giving a false statement regarding the matter, was arrested in July 2019. While in Vienna Austria, Dr. Lee consented to return to the United States to face the judges for his responsibility in fraudulently handling Serostim, a drug used to treat patients with HIV. According to the indictment returned by a federal grand jury a month earlier, he faced ten counts of three different allegations relating to healthcare fraud. The 72-year-old physician was allegedly running the scheme with others who were not indicted. However, the state legal team was committed to bringing more accomplishes to the court to answer various charges relating to the responsibilities they had in the scheme.
One count of the conspiracy that faced the doctor alleged he prescribed Serostim to health insurance beneficiaries such as Medicare who received benefits under part D for the costs of the drugs but diverted the drugs for sale to other people. It was alleged he would purchase back the drug from the insurance beneficiaries to stock and sell to bodybuilders and other users who were not HIV patients. However, he still billed the insurance companies to recover the illegal costs. He then sold the drugs at a much higher price due to its demand. The illicit diversion and sale of the medication was done in secrecy and was coordinated by the defendant according to the assertions of the investigators.
Dr. Lee further faced allegations that he colluded with other individuals in making falsified claims to private insurance companies and government-sponsored healthcare protection plans. Dr. Lee was making claims for Serostim drugs he administered to the patients covered under various insurance plans, including Medicare. However, the investigators argued the accused had not provided the required injections. As such, the patients who he attended were given the medication, but later, he repurchased them to sell to unauthorized people for nonmedical use. It was discovered that the doctor billed the insurers for amounts not indeed dispensed or for doses bought from other patients. The claims presented by the accused to the insurers were, therefore, fraudulent and invalid. The indictment evidence revealed the defendant caused losses to the insurers amounting to nearly 6 million dollars out of over 14 million dollars’ worth of claims submitted by him and his conspirators. Medicare alone claimed had lost 1.4 million dollars in these payments. He faced six counts of committing healthcare fraud.
Also, Dr. Lee was indicted for giving false statements regarding the healthcare fraud scheme that he orchestrated according to the court papers. In regard, the defendant was allegedly tried to coach the patients to tell lies to the investigators to cover up his crime. The prosecution claimed there was evidence of the accused interfering with the patients in meetings conducted by the accused. In the sessions, it was alleged he coached them how to tell lies and what to say if asked anything about Serostim. They illustrated that he had coached the patients to state the money they received from the doctor were overpayments from insurers. However, the investigators claimed he gave kickbacks, although he was not charged with violating ant kickback statute. He was also accused of providing false statements to authorities besides coaching others to do the same.
All the ten counts carry punitive consequences if the accused will be found guilty by a federal court. The conspiracy to commit healthcare fraud, for instance, has a 1-year-jail term. On the other hand, the false statement allegations are punishable by a jail term of five years while interfering with witness ha a stringent punishment of twenty years behind bars. It is unfortunate that even innocent practitioners could be accused of such claims and could be severely punished if found guilty.
Being accused while you believe you are innocent requires you to take action that will vindicate you. Therefore, if you have been accused wrongfully of any malpractice and you need a competent team of defense lawyers to maintain your innocence in court, you can navigate the turbulent legal process by contacting our team. Avoid these punitive measures by working with our criminal defense attorneys at Healthcare Fraud Group.