Lake Norman doctor pleads guilty to health care fraud
06/25/2014 1:21 PM
06/25/2014 2:09 PM
A Huntersville doctor, who prosecutors said hid $2.4 million in income to build an 8,000-square-foot home on Lake Norman, pleaded guilty Wednesday to health care fraud and tax evasion.
Internist Mark Tuan Le and his former Northcross Medical Center also have agreed to pay $6.2 million to settle a related civil fraud case.
That’s the largest settlement ever filed in the federal Western District of North Carolina against a single physician, according to the office of U.S. Attorney Anne Tompkins, which handled the criminal and civil cases against the physician.
Le, 55, pleaded guilty before U.S. Magistrate Judge David Cayer to seven counts of health care fraud, one count of conspiracy to commit health care fraud, and one count of tax evasion. He faces up to 10 years in prison and a $250,000 fine for the fraud charges, and five years and $250,000 for tax evasion. A sentencing date has not been set.
Tompkins said Le cheated taxpayers twice: wrongly billing insurers for unnecessary services, then hiding the income to avoid paying taxes.
Le, whose practice had offices in Charlotte and Huntersville, did not return a phone call to his home Wednesday seeking comment.
According to documents filed in his cases, he has admitted billing government and private insurers for tests and procedures that were either unnecessary or never performed, and evading more than $800,000 in taxes in 2009 and 2010.
In the civil case, Le was accused of bilking Medicaid and Medicare for hundreds of thousands of dollars in reimbursements for extraneous tests and procedures during 2009-13. Le and Northcross have already paid $2.1 million of the settlement and must pay the remaining $4.1 million in the next 18 months.
Documents also claim that Le hid millions of dollars in income that he funneled toward the construction of his massive lakefront home in Cornelius. He sent $2.4 million from his company account to the builders, prosecutors say, then claimed on his tax returns that the money was being spent on business expenses.
According to documents, Le hid $1.2 million in income in both 2009 and 2010. In 2010, when prosecutors say Le continued to funnel millions to the builders of his new home, the physician claimed taxable income of only $40,000 and paid the IRS $832.
As part of his criminal plea agreement, Le agreed to pay full restitution to Medicare, Medicaid, private insurers and to the IRS for any losses. The final restitution amount will be determined at Le’s sentencing hearing.
Le employed numerous family members at his practice and related businesses, records show. Most of the phony treatments for which he sought reimbursement – from removing hemorrhoids to treating heart problems – were ordered for his relatives or those of his employees.
On Tuesday, Le voluntarily surrendered his license to practice medicine to the N.C. Medical Board. He was disciplined by the board in May 2013 when he signed a consent order that avoided a public hearing on charges of unprofessional conduct.
Although Le denied engaging in fraudulent behavior, he agreed to a six-month suspension of his medical license, which ended on Dec. 31. He also agreed to pay a fine of $25,000.
The consent order says the board received five complaints about Le’s practice from December 2011 to December 2012. The complaints alleged inappropriate prescribing of controlled substances, inappropriate treatment of obesity, inappropriate self-referrals, overuse of medical tests and fraudulent billing for services.
He has had a state medical license since January 1997. Staff Writer Karen Garloch contributed.
Editor's Choice Videos
Join the Discussion
Charlotte Observer is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.