December 27, 2024 | JacobiJournal.com — Comp fraud case: Doctor Pleads Guilty: A Southern California doctor has agreed to plead guilty to defrauding the state’s workers’ compensation trust fund of over $3 million. The Justice Department announced that Dr. Kevin Tien Do, 59, of Pasadena, conspired to submit fraudulent claims to California’s Subsequent Injuries Benefits Trust Fund (SIBTF) even after being suspended from the program due to a prior healthcare fraud conviction.
Fraudulent Activities After Suspension
Doctor Pleads Guilty: Dr. Do’s plea agreement details his role in the scheme, which lasted from October 2018 to February 2023. Despite his suspension from California’s workers’ comp program in 2018, Do continued working for Liberty Medical Group Inc. in Rancho Cucamonga. He authored and edited medical reports used to claim compensation from the SIBTF. These reports were billed under the names of other doctors to hide his involvement.
Liberty’s owner, a co-conspirator who was neither a doctor nor a licensed medical professional, reportedly edited Do’s reports. Although California law requires medical corporation owners to hold medical licenses, this co-conspirator was a California attorney employed as a prosecutor for the Orange County District Attorney’s Office during the scheme and later became an Orange County Superior Court judge.
Concealing the Fraudulent Scheme
To obscure his participation, Liberty Medical Group submitted claims to the California SIBTF without listing Do’s name. Instead, the fraudulent claims listed other physicians, allowing Liberty to receive payments exceeding $3 million. Do’s plea agreement acknowledges that Liberty’s owner actively facilitated the fraud.
Tax Evasion and Financial Misreporting
In addition to the mail fraud conspiracy, Do admitted to filing a false tax return. Specifically, he failed to report $66,227 in income from Liberty Medical Group on his 2021 tax return, further violating federal law.
Maximum Penalties for Guilty Plea
Once Do formally enters his guilty plea, he will face significant legal consequences. For the mail fraud charge, he could receive up to 20 years in federal prison. The tax fraud charge carries a maximum sentence of three years. These potential sentences underscore the severe penalties for fraudulent activities and tax evasion.
Investigations and Prosecution
This case is being investigated by the FBI, IRS Criminal Investigation, and the California Department of Insurance. The prosecution team includes Assistant U.S. Attorneys Charles E. Pell of the Orange County Office and Ryan J. Waters of the Asset Forfeiture and Recovery Section.
To view the full report from the Justice Department, visit the official DOJ website.
FAQs: Workers’ Comp Fraud Case
What is workers’ comp fraud and how did it occur in this case?
Workers’ comp fraud happens when false claims are made to obtain benefits. In this case, Dr. Kevin Do submitted fraudulent medical reports to the California Subsequent Injuries Benefits Trust Fund.
Why is this workers’ comp fraud case significant for California?
It highlights ongoing vulnerabilities in the workers’ compensation system and shows how individuals exploited loopholes even after being suspended from the program.
What penalties can result from a workers’ comp fraud conviction?
Penalties may include up to 20 years in federal prison for mail fraud and additional prison time for related tax fraud violations, as seen in this case.
How can workers’ comp fraud impact taxpayers and businesses?
Fraudulent claims drive up insurance costs, drain public resources, and weaken trust in the compensation system designed to protect injured workers.
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