A St. Louis-area dentist has been charged with executing a
wide-ranging health care fraud scheme
over several years. Dr. Yun Sup Kim, 48, of St. Louis, is
under federal indictment for allegedly
defrauding Illinois Medicaid out of hundreds of thousands of
dollars from his dental office in
Swansea, Illinois. The 20-page indictment charges Kim with
12 counts of health care fraud and one
count of wire fraud in connection with his dental practice.
According to the indictment, from September 2014 through the
end of 2017, Kim repeatedly billed
Illinois Medicaid for cavity fillings and surgical tooth
extractions he never actually performed.
The experiences of 10 former patients are outlined in the
indictment, including several where Kim
allegedly claimed to have filled cavities on more than half
the patient’s teeth in one sitting. The
indictment charges those claims were false and alleges that,
in many instances, the teeth Kim
claimed to have filled never had cavities to begin with. Kim
is also accused of falsifying dates of
service on numerous occasions to evade billing rules
involving reimbursements for dental sealants.
On one particular occasion in 2016, the indictment alleges
that Kim billed Illinois Medicaid for a
dental exam, fluoride treatment, and tooth cleaning on a
10-month old girl who was not a patient
and had only two teeth at the time. This incident is the
subject of the wire fraud count, which
alleges that the claims were fraudulent and the services
never actually rendered.
An indictment is a formal charge against a defendant. Under
the law, a defendant is presumed to be
innocent of a charge until proven guilty beyond a reasonable
doubt to the satisfaction of a jury.
Kim is due in federal court for his initial appearance on
September 12 at 2:00 pm. A trial date has
not been set. Each charge of health care fraud is punishable
by up to 10 years in prison and a
$250,000 fine. The wire fraud count carries a 20-year
statutory maximum prison term. Supervised
release on each count is capped at three years. The
indictment also seeks forfeiture of
over $700,000 in fraudulent proceeds of the charged scheme.
The ongoing investigation is being conducted by the Illinois
States Police Medicaid Fraud
Control Unit, the U.S. Department of Health and Human
Services – Office of Inspector General, and
the FBI. Assistant U.S. Attorney Nathan D. Stump is
prosecuting the case
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