On behalf of the entire Allegiant Experts team, we hope you all enjoyed a very festive and safe Fourth of July! While our nation is, in no way, perfect, we’re certainly all very fortunate to call ourselves Americans. May we continue to grow together as a nation, truly unite and find even more reasons to celebrate our country’s birthday next year and every year thereafter.
This year, Independence Day wasn’t particularly worth celebrating for a 71 year-old, James T. Lee. As reported by Gail Pinsker in a report submitted to the Santa Monica Daily Press, the West Hollywood doctor was arrested in Vienna, Austria, this past Tuesday, on charged connected to a health care fraud scheme. He waived extradition and agreed to return to the United States.
The arrest follows a 10-count indictment from a federal grand jury on June 6th.
As Pinsker reports, “the indictment against Lee charges him with one count of conspiracy to commit health care fraud, six counts of health care fraud, one count of making false statements relating to health care matters, and two counts of witness tampering.”
The indictment contends that from at least May 2011 to February 2019, Lee wrote prescriptions for Serostim to HIV patients. Those patients then obtained the drugs and used their Medicare Part D benefits to pay for them. Lee then illegally purchased the Sersotim back from his patients in order to re-sell them for sizeable profits. His buyers were not HIV-positive, but instead were people who used the human growth hormone for the purposes of bodybuilding.
The second part of Lee’s scheme, according to the indictment, alleges that the doctor submitted claims to health insurance companies for Serostim injections. However, these claims were fraudulent because Lee never actually provided the Serostim injections to any of his patients. “According to the indictment, many of the patients did not receive the full amount of Serostim that Lee billed to the insurance companies, or they received Serostim that Lee had purchased from other patients,” reports Pinsker.
Lee is out on bail.
Although Lee was brought back to the U.S. from Austria to face his charges, he narrowly escaped spending the Fourth of July in prison by posting his $500,000 bail, WeHoVille.com tells us. His trial date is tentatively set for September 3rd. He will be fighting allegations that he engaged in a scheme to divert Serostim from legitimate HIV patients to other people who purchased the drug for cosmetic purposes.
As explained by Pinsker, The Food and Drug Administration has approved Serostim for use only by HIV patients with wasting or cachexia who are also receiving antiretroviral therapy. Not only is the sale of the drug to people without prescriptions illegal, Lee’s falsified insurance claims robbed insurance companies of approximately $5.9 million.
According to Pinsker’s report, “Medicare paid at least $1.4 million based on Serostim prescriptions that were issued by Lee and filled by patients who sold at least some of the drugs to Lee.
Are you an attorney who is currently trying a health care fraud case?
Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help your case. Give us a call at 407-217-5831 or email us at info@allegiantexperts.com.