Physician Admits $3M SIBTF Fraud Naming O.C. Judge as Co-Conspirator – Employment Law Weekly

Physician Admits $3M SIBTF Fraud Naming O.C. Judge as Co-Conspirator

According to the California Medical Board records, Kevin Tien Do M.D.was born in Saigon, Vietnam and came to the United States in 1982, when he was 16 years old. He graduated from USC Medical School in 1991 and completed his residency in Physical Medicine and Rehabilitation at UCLA on June 30, 1995.

After about eight years following completion of his UCLA Residency, Dr. Do was convicted, on on August 15, 2003, following his plea of guilty, of violating Title 18, United States Code, sections 2 and 1347 (aiding and abetting health care fraud in the United States District Court for the Eastern District of California, Case Number 2:02CR00338-01, entitled The United States of America v. Kevin Tien Do,

He was sentenced to 12 months in federal prison, commencing October 15, 2003, and ordered to pay an assessment of $100 and restitution of $366,031.24

From April of 1997 through December 31, 1998, he aided and abetted a billing company named “Medi-Syn” in a scheme to defraud Medi-Cal. He permitted Medi-Syn to use hisr Medi-Cal provider number to submit claims requesting payment for services purportedly rendered by him which he did not provide and which were never provided by anyone else. Do Medi-Syn opened a joint account under the name “Premier Health Providers Network” into which the Medi-Cal checks were deposited. Do provided 80 percent of these funds to Medi-Syn and kept 20 percent for himself. As a result of the scheme, Medi-Cal was defrauded out of $366,031.24.

In order to obtain leniency in the 2003 case against him, Do agreed to act as an undercover operative and to cooperate with the FBI in its investigation of Edgemont Hospital a psychiatric hospital in Los Angeles, and in a third investigation regarding podiatrist Gary Feldman and the West Pico Medical Clinic where Do worked. He participated in 43 undercover operations from December of 1998 through May of 1999. He also provided additional assistance in 2000. Respondent’s cooperation led to the conviction of Dr. Feldman.

Do began serving his federal prison sentence in the 2003 case on October 15, 2003, and was officially released from custody on October 13, 2004. He remained on federal probation until October of 2007.By 2004, Do had paid in full the $366,03 1.24 restitution ordered by the criminal court.

The Physician’s and Surgeon’ s Certificate No. G 76640 issued to Kevin Tien Do was revoked in late 2005 after an Accusation was filed against him by the California Medical Board. However, the revocation was stayed and he was placed on probation for ten years under several terms and conditions.

On October 26, 2016 the Medical Board concluded that Dr. Do had “completed probation in Case No. 06-2002-136106, is entitled to full restoration of the Physician’s and Surgeon’s Certificate.” It was therefore ordered that his medical license “be fully restored to renewed/current status and free of probation requirements, effective September 22, 2016.”

Now, more than two decades after his 2003 conviction,,Kevin Tien Do, M.D., who is now 59 years old and lives in Pasadena, worked for an Inland Empire medical company, and has now agreed to plead guilty – in new case – to conspiring to defraud California’s workers’ compensation fund of millions of dollars by continuing to work on workers’ compensation matters after being suspended due to a prior health care fraud conviction. He agreed to plead guilty to one count of conspiracy to commit mail fraud and one count of subscribing to a false tax return. .

Beginning in 2016, Do began to work for Liberty Medical Group Inc., a Rancho Cucamonga-based medical company, for which he would draft SIBTF-related medical reports that Liberty would then bill to the California SIBTF program. In October 2018, California suspended Do from participating in California’s workers’ compensation program, which included the SIBTF, because he had previously been convicted of federal health care fraud in 2003. Despite his suspension, Do continued to work for Liberty on SIBTF-related workers’ compensation matters.

In October 2018, California suspended Do from participating in California’s workers’ compensation program, which included the SIBTF, because he had previously been convicted of federal health care fraud in 2003. Nonetheless, Do continued to perform similar actions for Liberty that he had been doing before his October 2018 suspension, including compiling and editing reports related to the SIBTF program.

To conceal that Do was unlawfully continuing to participate in the workers’ compensation SIBTF program after his suspension, Liberty’s owner came up with a plan. That plan was that Do would continue to author the SIBTF-related reports, which Liberty would then continue to mail to the California SIBTF for payment. rather than listing Do’s name on the billing forms and the attached medical reports mailed to the California SIBTF, like they had had done before Do’s suspension, Liberty instead fraudulently listed other doctors’ names on the billing forms and attached medical reports, even though Do had drafted and compiled the reports.

Do admitted that Liberty was paid more than $3 million by California SIBTF for such reports that Liberty mailed to the California SIBTF for payment after Do’s October 2018 suspension.

Do’s plea agreement also details that Liberty’s owner edited Do’s medical reports, even though that co-conspirator was not a doctor or other licensed medical professional.

Under California law, shareholders/owners of a medical corporation must be licensed in the practice of medicine or other related medical fields, such as a psychologist, registered nurse, or licensed physician assistant. In his plea agreement, Do admitted that real owner of Liberty and Do’s co-conspirator was another person who was not a doctor or other medical professional, but rather, was a California attorney then employed as a prosecutor for the Orange County District Attorney’s Office, and who later became an Orange County Superior Court judge during the conspiracy.

According to the Orange County Register, the Orange County Superior Court Judge named in the plea agreement is Israel Claustro, Claustro has served as a Senior Deputy District Attorney and an Assistant Head of Court at the Orange County District Attorney’s Office since 2020, where he has served in several roles since 2002. He served as a Law Clerk at the Orange County District Attorney’s Office from 2001 to 2002. Claustro earned a Juris Doctor degree from the Western State College of Law.

And MSN reports that the plea agreement with the Do refers to the judge only as “co-conspirator #1,” but an investigation by the Southern California News Group has identified the jurist as Israel Claustro, who was appointed to the bench in 2022..

A reporter’s request for comment from Claustro was relayed to him through Orange County Superior Court officials. In response, court spokesperson Kostas Kalaitzidis said, “The court cannot discuss any case pending before any court, as ethical rules prohibit any such discussion.”

Officials with the U.S. Attorney’s Office declined to comment. Additionally, the state Commission on Judicial Performance would not disclose whether it is investigating Claustro,

That true owner who was Do’s co-conspirator not only was a signatory on Liberty’s bank account, but also issued and signed Liberty’s checks to Do and others. The plea agreement specifies that much of the more than $3 million that the SIBTF paid Liberty during the years following Do’s suspension then flowed to another company controlled by Liberty’s owner and his wife, which totaled to more than $1.5 million.

Do also admitted that he failed to accurately report to the IRS all the money he had been paid by Liberty. Do admitted that on his 2021 tax return, he failed to report approximately $66,227 of the income that Liberty paid him.

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

The FBI, IRS Criminal Investigation, and the California Department of Insurance are investigating this matter. Assistant United States Attorneys Charles E. Pell of the Orange County Office and Ryan J. Waters of the Asset Forfeiture and Recovery Section are prosecuting the case.

Physician Admits $3M SIBTF Fraud Naming O.C. Judge as Co-Conspirator

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