John Keun Sang Lee, MD, a 79 y/o PM&R physician in Pittsburgh, Pennsylvania, pleaded guilty November 4, 2022 in federal court to one count of health care fraud. In his plea, Dr. Lee admitted  that between May 2016 and October 2020, he knowingly and willfully submitted claims for steroid injections to Medicare and Medicaid that were neither reasonable nor medically necessary.

As part of his plea agreement, Lee has agreed to pay $264,730 in restitution to the United States Department of Health & Human Services and $153,230 to the Pennsylvania Department of Human Services for losses associated with the fraudulent billings. Lee also has agreed to voluntarily surrender his medical license and DEA registration and not to maintain any ownership or management interest in any medical clinic or facility. He had already planned to retire, so this just fits in.

He was originally indicted in May, 2021 on 242 charges of violating federal narcotics laws and health care fraud.  The indictment charged him with knowingly distributing Schedule II controlled substances including oxycodone, morphine, fentanyl patches and more to five patients outside the usual course of professional practice and not for a legitimate medical purpose. But since he was willing to plea to the fraud, I imagine the government decided to not pursue the opioid prescribing even though it doesn’t appear that Ruan/Kahn decision has stopped them from this in other cases.

According to the government’s press release, former patients and employees reported that Dr. Lee

1. Required patients to submit to “repetitive and medically unnecessary” steroid injections, even when patients reported that the injections were not helping but rather causing them more pain and other injuries.
2. Instructed employees to withhold patient medication if patients objected to the injections.
3. Directed staff to use templates indicating that patients received 80% relief from prior pain injections in order to justify billing insurance companies for the medically unnecessary injections.
4. Required some patients to change their insurance providers so he would get a larger reimbursement.

My Thoughts: It’s About Time

It’s about time that the government start charging these interventional doctors that force steroid injections on their patients with the crime that it is.  This has been going on for years, and they have gotten away with it in spite of the reviews by the insurance companies on procedures. I can speak personally about two cases.

Murray Joiner, MD is a PM&R doctor in my town, Roanoke, VA.  He has been forcing patients to take steroid injections since back when I started treating pain in the early 2000’s.  When the government came after me for actually healing my patients of disease, I always wondered how come Dr. Joiner got away with the fraud he was committing.  He would require the steroid injections in order for the patients to receive their opioids. And then, when he had done all the injections that the insurance company allowed, he would discharge the patient, saying “There’s nothing more I can do for you.”  He is still in practice, as far as I know, still doing the same thing.

Then there is Marc Swanson, MD.  He is an anesthesiologist in Roanoke, VA. Now he limits his CMS patients.  He was the government witness against me in my trial in 2013, and when asked about treating Medicaid patients, he spoke with derision saying “We don’t deal with that type of patient”. But I know he takes all of the private insured that he can, and the government now works with Anthem, Cigna, etc. to charge their doctors criminally as well. Dr. Swanson also does steroid injections liberally. And nothing has happened to him either.

It is especially wrong to force steroid injections on to pain patients because they can often lead to adhesive arachnoiditis. This is a condition that conventional medicine cannot treat, and once a patient has it, the pain is excruciating and forever.

So now that the attacks on opioid prescribing might be slowed down by the Ruan/Kahn decision to a slight degree, it is possible that these money-hungry interventionists will become targets.  I can give a few more names if the government wants.  Such as the doctors sitting on the Virginia medical board who are preventing me from having my license reinstated because they want to do these outrageous procedures on pain patients for the money.  And Dr. Lee, if for once, the media reports on your care are correct, you are getting what you deserve.  In fact, you are getting off light.