An Alexandria woman was sentenced this week to two years and two months in prison for repeatedly submitting fraudulent health insurance claims and illegally collecting $128,748 in payments to which she was not entitled.

According to court documents, in 2018, Khin Phoo Ngon, aka Karen Ngon and Kyaw Zaw Ni, 27, was a student at George Washington University and enrolled in a study-abroad program in Sydney, Australia. Ngon purchased a health insurance policy through Cultural Insurance Services International (CISI), a company that provides health insurance for study-abroad students and educational travel groups. 

On Nov. 13, 2018, Ngon submitted a fraudulent claim for reimbursement for an appendectomy, purportedly performed at St. Vincent’s Hospital in Sydney, along with a forged invoice for $107,368.31 in Australian currency (approximately $79,715 U.S.). The claimed dates of service were Oct. 28-29, 2018, during which time Ngon was in the United States. CISI paid the claim.

In 2019, Ngon enrolled in another study-abroad program, this time in Zurich, Switzerland. Ngon traveled to Switzerland, but withdrew from the program and returned to the United States on June 10, 2019. Prior to returning, however, Ngon submitted a fraudulent claim to CISI for treatment for a “minor heart attack,” along with a forged invoice from University Hospital of Zurich for 48,670 Swiss francs (approximately $49,029 U.S.). Ngon received treatment at University Hospital of Zurich, but the actual payment was 800 Swiss francs. CISI paid the claim, and Ngon used proceeds from the second reimbursement to pay restitution in a prior criminal case in which she committed fraud and identity theft.

Ngon later purchased a second policy through CISI. On July 23, 2019, she submitted a fraudulent claim, asserting that she had had her appendix removed again at St. Vincent’s Hospital in Sydney, along with a forged invoice for $152,368.31 Australian (approximately $106,606 U.S.). The claimed dates of service were July 14-15, 2019, and, again, Ngon was in the United States on the purported dates of service. This time, CISI denied the claim.

On Dec. 18, 2019, Ngon submitted a fourth claim, this time for emergency dental care in Brussels, Belgium, along with forged records indicating she had paid €15,175 to a dentist and €3,719 to a pharmacy (approximately $21,040 U.S.). The claimed date of service was Dec. 16, 2019, on which date Ngon was in the United States. CISI denied this claim as well.

Additionally, Ngon recently pled guilty to fraud and identity theft charges in the District of Columbia in connection with a scheme she engaged in to defraud a pandemic relief program. In response to the COVID-19 pandemic, the District of Columbia implemented the STAY DC program, a means-tested program to provide financial relief to qualifying renters experiencing financial hardship. Beginning in 2021, Ngon submitted fraudulent applications for relief through the program, four times in her own name and three times in the names of others, including one person who did not live in Washington, resulting in program payouts that cost the District of Columbia more than $246,000. On April 23, Ngon pled guilty in the D.C. Superior Court to six charges related to the fraud on STAY DC. Sentencing in that case is set for Aug. 9.

Source: U.S. Attorney’s Office for the Eastern District of Virginia