Former chiropractor sentenced to nearly six years in federal prison for fraudulently submitting $2.2 million in bills to health insurers | USAO-CDCA
SANTA ANA, California – A former Orange County chiropractor was sentenced today to 70 months in federal prison for robbing health insurers by fraudulently causing the submission of $2.2 million in bills for chiropractic services never provided, diagnostics never given, office visits that never happened, and medical devices that were wrongly prescribed.
Susan H. Poon, 57, of Dana Point, was sentenced by U.S. District Judge David O. Carter, who ordered her to pay $1,379,622 in restitution to his victims.
Following a five-day trial in June 2021, a federal jury found Poon guilty of five counts of health care fraud, three counts of misrepresentation relating to health matters and a count of aggravated identity theft.
From January 2015 to April 2018, Poon, whose office was in Rancho Santa Margarita, conspired to defraud health insurance companies by submitting false claims for reimbursement for services that were never performed.
Poon also submitted fraudulent prescriptions containing medical diagnoses from people she had never met, including toddlers and children, leading a medical device manufacturer to submit bogus claims to a health insurer.
The patients Poon said he saw and treated were dependents — such as spouses and children — of Costco Wholesale Corp employees. and United Parcel Service Inc. Poon unlawfully took and used the dependent’s Personally Identifiable Information (PII) in his claims and prescriptions. Poon obtained the PII by attending health fairs at various UPS warehouses and Costco locations and soliciting this information from employees.
“[Poon’s] The system consisted of interdependent moving parts,” prosecutors wrote in a sentencing memorandum. “She lied about visits, diagnoses and treatments given to real people and their children. She sent fraudulent durable medical equipment (DME) prescriptions — based on visits with these patients that never happened — to an EMR manufacturer. And she fabricated medical documents containing the personal identifying information of these “ghost” patients to fool an auditor.
In total, Poon has billed and been billed approximately $2.2 million through his scheme.
Poon’s chiropractic license was revoked in July 2019, according to the California Department of Consumer Affairs.
The following agencies investigated this matter: Amtrak – Office of Inspector General, California Department of Insurance, US Department of Labor – Benefits Security Administration, State Department of Labor Office of Inspector General United States, FBI and Office of Personnel Management – Office of Inspector General.
Assistant United States Attorneys Daniel S. Lim and Daniel H. Ahn of the Santa Ana Branch prosecuted the case.