CA Doctor to Plead Guilty to Conspiring with Attorney to Defraud SIBTF of $3 Million

The Justice Department recently announced that a physician from an Inland Empire medical company has agreed to plead guilty to conspiring to defraud California’s workers’ compensation fund of millions of dollars. The physician, who had been suspended due to a prior healthcare fraud conviction, continued to work on workers’ compensation matters. CA Doctor Defraud SIBTF

Details of the Conspiracy

Dr. Kevin Tien Do of Pasadena agreed to plead guilty to one count of conspiracy to commit mail fraud and one count of subscribing to a false tax return. He is expected to make his initial appearance in United States District Court in Santa Ana soon.

In his plea agreement, Do admitted that from October 2018 to February 2023, he conspired to defraud California’s Subsequent Injuries Benefits Trust Fund (SIBTF) of millions. The SIBTF provides additional compensation to injured workers who had pre-existing disabilities or impairments at the time of a subsequent injury.

Involvement with Liberty Medical Group Inc.

Starting in 2016, Do worked for Liberty Medical Group Inc., a Rancho Cucamonga-based medical company, drafting SIBTF-related medical reports. These reports were billed to the California SIBTF program. However, in October 2018, California suspended Do from participating in the workers’ compensation program, including the SIBTF, due to a prior federal healthcare fraud conviction in 2003. Despite the suspension, Do continued to work for Liberty on SIBTF-related matters.

Do’s actions for Liberty remained consistent with his pre-suspension duties, including compiling and editing SIBTF reports. To hide Do’s involvement post-suspension, Liberty’s owner devised a plan. Liberty continued to submit the SIBTF-related reports, omitting Do’s name from the billing forms and medical reports. Instead, they fraudulently listed other doctors’ names, even though Do was the one drafting the reports. CA Doctor Defraud SIBTF

Fraudulent Payments and Concealment

Do admitted that Liberty received more than $3 million from the California SIBTF for these reports. The plea agreement reveals that Liberty’s owner, who was not a licensed medical professional, edited Do’s medical reports. This fraudulent practice led to significant financial gains for Liberty and its owner.

Under California law, shareholders or owners of a medical corporation must be licensed medical professionals. Do’s co-conspirator, the true owner of Liberty, was not a medical professional but rather a California attorney who later became an Orange County Superior Court judge during the conspiracy. This attorney was a signatory on Liberty’s bank account and signed checks issued to Do and others. Over $1.5 million of the payments from SIBTF flowed to another company controlled by the attorney and his wife.

Tax Fraud Admission

Do also admitted to failing to accurately report his income to the IRS. Specifically, on his 2021 tax return, he did not report approximately $66,227 of income received from Liberty.

Potential Sentencing

Once Do enters his guilty plea, he faces a statutory maximum sentence of 20 years in federal prison for the mail fraud count and up to three years for the tax fraud count.

Investigation and Prosecution

The FBIIRS Criminal Investigation, and the California Department of Insurance are investigating this matter. Assistant United States Attorneys Charles E. Pell and Ryan J. Waters are prosecuting the case.

For further information, visit the US DOJ website. Additionally, more related topics can be explored on MedLegalNews.

Source: US DOJ

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