Wahiawa doctor settles
for $2 million in Medicare
and HMSA fraud suit

He billed for drugs prescribed
by an unlicensed worker

By Debra Barayuga
Star-Bulletin

A WAHIAWA PHYSICIAN has entered into a $2.1 million settlement with the U.S. government to resolve a civil lawsuit accusing him of fraudulently billing the state's Medicaid program and HMSA during a six-year period.

The False Claims Act lawsuit was filed by a former employee who worked as a medical technician in the office of Dr. Sze Ming Suen from 1985 to 1990.

As part of the settlement, the unnamed employee, who was instructed by Suen to dispense prescription drugs to patients and prepare the billings, will receive $464,000 for reporting the fraud and initiating the lawsuit.

Suen, 63, owner of Wahiawa Clinic Inc., pleaded guilty yesterday to one count of mail fraud and one count of submitting a false claim to an agency of the United States.

He also may face a maximum penalty of five years in prison and a fine of up to $250,000 on each felony count.

Suen has been practicing medicine since 1972 at Wahiawa General Hospital and also ran Wahiawa Clinic Inc. in the Wahiawa Shopping Center. He is an authorized provider with the Hawaii Medical Service Association and the state Medicaid program.

Suen admitted yesterday he allowed a pharmacy technician to order and dispense drugs without his supervision and knew she did not have a license.

Under state law only licensed physicians and pharmacists can dispense prescription drugs.

He also admitted to submitting claim forms stating he personally performed services when it was the technician who had dispensed the drugs.

In the 14-count indictment filed against Suen in April, the government also alleged that he provided his patients with generic, cheaper drug equivalents but billed for more expensive brand-name drugs or for drugs he did not actually provide.

Assistant U.S. Attorney Larry Tong said HMSA and Medicaid had to divert large sums to pay for Suen's false claims, and those who were insured by HMSA and the public were hurt economically.

"Every dollar lost to a fraudulent claim was money that could have been provided to some other needy person."