Medicare dollars have become such easy pickings that cheating the federal government and U.S. taxpayers has become pervasive in every corner of the health care industry. Chiropractors, nursing home operators, psychiatrists and others have gotten in on the act, and now an acupuncturist has been caught with his hand in the cookie jar.
The needle sticker in question is Sinkweon Park, 43, of Suwanee, Georgia. Park was sentenced to two years, nine months in prison and ordered to pay restitution of $1.2 million. The sentence came after Park pleaded guilty to one count of conspiracy to commit health care fraud.
Park owned and operated the LOMA Clinic in Norcross, Georgia. Beginning in April 2010, the clinic began submitting false claims to Medicare in three different ways.
First, Park, a licensed acupuncturist, submitted claims for acupuncture treatments, which were not reimbursable by Medicare under any circumstances. Second, LOMA billed for massage and physical therapy services that were not performed by licensed physical therapists or physical therapy assistants, as required by Medicare. Third, LOMA billed Medicare for office visits supposedly performed by a medical doctor. In fact, the doctor hired by LOMA to serve as medical director of the clinic never examined or treated patients. Yet, all of LOMA’s claims were submitted using his unique provider code. Similar false claims were made to Blue Cross Blue Shield.
Over two years, LOMA submitted more than $1.6 million in false claims to Medicare, along with an additional $475,000 in false BCBS claims. Based on the claims, Medicare paid LOMA over $969,000, and LOMA received over $210,000 from Blue Cross.
At least this guy got caught. There are many more like him still operating. They also need to be brought to justice.
In other health care fraud news:
- The managers of three Los Angeles, California, medical clinics were charged with Medicare fraud and conspiracy to pay illegal kickbacks for medical procedures that were never actually provided. Hovik Simitian, 47, and Anahit Shatvoryan, 49, ran three medical clinics – Columbia Medical Group, Life Care Medical Clinic and Safe Health Medical Clinic, from two suites in the same Los Angeles office building. From 2010 to 2014, they paid marketers illegal kickbacks to recruit Medicare beneficiaries to the clinics. They then submitted false claims to Medicare for services that were not medically necessary and were never actually provided. In that time period, the clinics allegedly submitted a total of $4.5 million in false and fraudulent claims to Medicare, and Medicare paid $1,668,559 on those claims.