Former Pain Management Doctor Sentenced for Health Care Fraud

PITTSBURGH - A former physician was sentenced in federal court today following his conviction for health care fraud, Acting United States Attorney Troy Rivetti announced today.

United States District Judge W. Scott Hardy sentenced John Keun Sang Lee, age 80, to five years of probation. Lee also was ordered to pay restitution totaling $417,960.51 to Medicare and Medicaid, as well as a fine of $50,000. Lee already had forfeited his Drug Enforcement Administration number and Pennsylvania state license to practice medicine prior to the sentencing hearing.

According to information presented to the court, between in and around May 2016 to in and around October 2020, Lee, a physician who owned a pain management practice, Jefferson Pain and Rehabilitation Center, 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.

Assistant United States Attorney Karen Gal-Or prosecuted this case on behalf of the government.

The investigation leading to the filing of charges in this case was conducted by the Western Pennsylvania Opioid Fraud and Abuse Detection Unit (OFADU). The Western Pennsylvania OFADU, led by federal prosecutors in the U.S. Attorney’s Office, combines the expertise and resources of federal and state law enforcement to address the role played by unethical medical professionals in the opioid epidemic.

The agencies which comprise the Western Pennsylvania OFADU include: Federal Bureau of Investigation, U.S. Health and Human Services – Office of Inspector General, Drug Enforcement Administration, Internal Revenue Service-Criminal Investigation, Pennsylvania Office of Attorney General - Medicaid Fraud Control Unit, Pennsylvania Office of Attorney General – Bureau of Narcotic Investigations, United States Postal Inspection Service, U.S. Attorney’s Office – Criminal Division, Civil Division and Asset Forfeiture Unit, Department of Veterans Affairs-Office of Inspector General, Food and Drug Administration-Office of Criminal Investigations, U.S. Office of Personnel Management – Office of Inspector General and the Pennsylvania Bureau of Licensing.