A man who offered physical therapy in the Boston area starting in 2009 proceeded to submit bogus claims to health insurers the same way he had previously defrauded insurers in other states, which led to him losing his license in Colorado, New York, Washington, DC and California, according to an indictment unsealed today in US District Court in Boston.
Chang Goo Yoon faces charges of health-care fraud and aggravated identity theft related to the various physical-therapy concerns he ran between 2009 - when he set up shop here after being barred in other states - and 2020.
The affidavit charges Yoon used a variety of corporate names and supposed addresses in Brookline, Allston and Waltham to try to throw insurers off the scent, including Boston Pain & Rehab Center, Doctor Physical Therapy, Lee Chiropractic, Doctors Medical Physio Group, D Physio Group, Doctors Physio Group, Hana Rehab Clinic, Doctors Physio Allston, Plus Chiropractic, Boston Top Center and Hana Pain Rehab Clinic.
Blue Cross Blue Shield became suspicious of him in 2015 and soon found evidence he had billed the insurer for services he had never performed:
Patient 1 identified 27 dates of service for which BCBS was billed, but Patient 1 was not present. Patient 1 used a Google calendar to keep track of all his/her appointments. On those 27 dates, Patient 1 was traveling and not present in the Boston area at all.
The BCBS investigation also revealed that YOON submitted a claim in March 2019 listing the home address of Patient 3 as 237 Moody St., Apt. 470, Waltham, MA 02453 - YOON’s home address. Based on my training and experience, I believe YOON submitted this address so that Patient 3 would not receive the Explanation of Benefits paperwork sent by the insurance company, which may have alerted Patient 3 to the fact that YOON was billing for visit dates that never occurred.