Former Chiropractor Found Guilty of Health Care Fraud Charges that She Schemed to Defraud Health Insurers Out of $2.2 Million
A former Orange County chiropractor was found guilty by a jury today of federal criminal charges accusing her of defrauding health insurers by fraudulently submitting and causing to be billed $2.2 million in billings for chiropractic services never provided, bogus medical diagnoses, office visits that never occurred, and medical devices falsely prescribed.
Susan H. Poon, 56, of Dana Point, was found guilty of five counts of health care fraud, three counts of making false statements relating to health care matters, and one count of aggravated identity theft in the first criminal jury trial to occur in the Central District of California since March 2020.
According to the evidence presented at her five-day trial, from January 2015 to April 2018, Poon, whose office was located in Rancho Santa Margarita, schemed to defraud Anthem and Aetna by submitting false reimbursement claims for services that never occurred, false diagnoses and chiropractic services that were never performed.
Poon also submitted fraudulent prescriptions containing fabricated medical diagnoses of individuals that she had never met, including children, causing a medical device manufacturer to submit false claims for reimbursement to Blue Shield of California.
The patient-victims that Poon claimed to have met with and treated were dependents – such as the spouses and children – of Costco Wholesale Corp. and United Parcel Service Inc. employees, dependents whose personal identification information Poon unlawfully took and used in her reimbursement requests and prescriptions. Poon obtained the personal information of employee-dependents by attending health fairs at various UPS warehouses and Costco locations, and soliciting such information from employees.
In total, Poon billed and caused to be billed approximately $2.2 million through her scheme.
Poon’s chiropractic license was revoked in July 2019, according to the California Department of Consumer Affairs.
United States District Judge David O. Carter has scheduled an August 30 sentencing hearing, at which time Poon will face a statutory maximum sentence of 67 years in federal prison.
The following agencies investigated this matter: Amtrak – Office of the Inspector General, California Department of Insurance, U.S. Department of Labor – Employee Benefits Security Administration, U.S. Department of Labor – Office of the Inspector General, the FBI, and Office of Personnel Management – Office of the Inspector General.
Assistant United States Attorneys Daniel S. Lim and Daniel H. Ahn of the Santa Ana Branch Office are prosecuting this case.
Source: U.S. Attorney’s Office, Central District of California