Virginia woman convicted in $83 million insurance fraud

Virginia woman convicted in $83 million insurance fraud | Insurance Business

Virginia woman convicted in $83 million insurance fraud

A Virginia woman has been convicted on charges of scamming $83 million from Medicare and private insurers.

Yung Yi, 44, ran the 1st Class Sleep Diagnostic Center and 1st Class Medical. She was convicted Monday of seven counts of healthcare fraud, one count of conspiracy to commit healthcare fraud and wire fraud, one count of conspiracy to defraud the United States and one count of filing a false tax return, according to local news affiliate WTOP.

According to prosecutors, patients referred by their doctors to 1st Class for sleep studies were also solicited to participate in “supplemental but medically unnecessary studies.” Yi hid the scam by telling her employees not to send the results of those studies to doctors. She also told the patients there was no co-payment or co-insurance for the supplemental studies and cross-billed patients from each of the 1st Class entities, WTOP reported.

Authorities said that Yi also encouraged her own employees to get unnecessary sleep studies. For example, three 1st Class employees had 27 sleep studies done among them in less than three years – even though none of them had sleep apnea. Teams of workers also held competitions to see who could refer the most friends and relatives for unnecessary studies, WTOP reported.

Authorities said that Yi used the money she made from the fraud to buy fur coats, luxury vehicles and real estate, including a $1.1 million house and a condo, as well as properties in Chicago and Honolulu. All the properties were booked as business expenses. She also created a fraudulent charity to hide the money from law enforcement, according to WTOP.

“When someone commits healthcare and tax fraud, it drives up the cost of care for everyone and creates an unlevel playing field,” said US Attorney G. Zachary Terwilliger. “Yi misled patients and their doctors, falsified records to cover it up, and deducted millions in taxes she used to buy expensive properties and luxury goods.

Yi will be sentenced in November.

 

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