An Anchorage doctor and her husband pleaded guilty to executing a $12.5 million healthcare fraud scheme and evading over $4 million in taxes on the profits of their decades-long scheme. According to court documents, Dr. Claribel Tan, 61, and her husband, Daniel Tan, 70, operated a rheumatology medical clinic in Anchorage. Dr. Tan specialized in the treatment of autoimmune and musculoskeletal diseases, such as rheumatoid arthritis, osteoarthritis, and psoriatic arthritis, and prescribed injectable medications to treat those conditions. Mr. Tan performed office and management work for the clinic. As part of their scheme, the Tans deceived their patients about the medications Dr. Tan administered by injection in the office, and fraudulently billed health insurance plans for reimbursement of medications that the Tans did not purchase.
Beginning in 2009, Dr. Tan routinely and surreptitiously underdosed patients, injected them with free samples or a different medication than prescribed, injected them with expired medication, and/or injected them with medications purchased by other patients. The Tans then knowingly billed insurance plans as if Dr. Tan had provided each patient a full and proper injection. Specifically, the Tans claimed to have administered 4,829 units of the medications to patients, and billed the insurance plans for that amount, despite only purchasing 369 units of medication. Mr. Tan helped execute the scheme in part by creating and submitting fraudulent insurance claims and ordering insufficient medication for the clinic. The Tans also made false statements about the length of Dr. Tan’s office visits with her patients and submitted fraudulent claims to insurance plans for services that Dr. Tan never provided. The Tans’ fraud scheme created significant health risks to the patients and caused a loss of approximately $12,522,446 to more than 10 insurance plans.