Family physician sentenced to 4-year prison term for largest doctor billing fraud in Alberta history

An Edmonton family physician has been sentenced to four years in prison for a crime described as the largest billing fraud by a doctor in Alberta history.

In 2016, Dr. Yifei Shi billed Alberta Health for a total of $1,388,862. According to an agreed statement of facts entered in Court of King's Bench on Thursday morning, $827,077 of that amount was fraudulent.

Shi claimed false billings that year for non-existent psychiatric counselling and treatment for hundreds of patients. 

"She would bill for psychiatric counselling on almost every patient she saw," the court document states. "She did not provide psychiatric treatment to her patients in the amounts that she claimed to Alberta Health."

Now 35, Shi was charged in April 2021 by Edmonton police with one count each of fraud over $5,000 and theft over $5,000.

She pleaded guilty Thursday to the fraud charge.

When Shi was charged, police alleged she had over-billed the Alberta government up to $4.1 million in a fraud scheme that dated back to 2013, but Shi only admitted to committing fraud in 2016.

• Edmonton doctor charged in alleged $4M overbilling fraud scheme

After Shi was charged, she was allowed to continue practising medicine, but all the money claimed through billings was held in escrow by Alberta Health, amounting to $582,000 in effective compensation to the provincial government.

Shi's lawyer, Kent Teskey, told court Thursday that the family doctor dipped into her own savings to pay for office overhead and staffing costs after she was charged.

"In the face of criminal charges, she continued to work, knowing that money would be held," Teskey told the court. "She's been serving her patients. They appreciate the fact that she continued to practise."

Teskey said his client is remorseful. Court of King's Bench Justice Paul Belzil agreed that giving up that money was a sign of remorse. 

In addition to the four-year prison sentence, Belzil also ordered Shi to pay back $827,077 in full restitution.

The judge accepted a submission from Crown prosecutor Megan Rosborough that Shi's crime is the largest billing fraud by a doctor in Alberta history.

'The only reason she did it was greed'

Rosborough asked the judge to impose a five-year prison sentence, noting that at the time she committed fraud, Shi had a happy family and was extremely well-educated with a dream job that had high earning potential.

"She committed fraud on a daily basis, often multiple times a day, over the course of a year," Rosborough said. "The only reason she did it was greed.

"We trust doctors with our lives," the prosecutor added. "We should be able to trust them with our money." 

Teskey, Shi's lawyer, suggested a sentence in the range of 24 to 30 months. 

"She's shown grace with this plea," he said. "This is a very unique fraud, but it's a very unique offender here." 

He pointed to many of the victim impact statements supporting Shi, despite the charge and her guilty plea. 

"She made me feel safe, cared for," one patient wrote. "When I received the news she is pleading guilty and closing her practice, I cried. I am beyond saddened to lose her."

Another patient described Shi as "a kind, compassionate doctor with great bedside manner," but said what the doctor wrote in her chart and billed Alberta Health in her name caused her "great concern and anxiety." 

Other patients wrote about feeling betrayed by Shi. 

"I feel completely violated and vulnerable," one patient wrote. Another asked, "How does a doctor intentionally hurt someone?"

Many of the patients said they felt abandoned during a time when it's difficult to find a family doctor.

"Never in a million years did I think a doctor would do this," one patient wrote. "So, so angry." 

Medical licence could be permanently revoked

A letter from a lawyer representing Shi in her dealings with the College of Physicians and Surgeons of Alberta was entered as an exhibit Thursday.

In the letter, dated Nov. 9, James Heelan said a conviction would likely lead to the college seeking to permanently revoke her licence.

He added that if Shi is successful in convincing a hearing panel that revocation of her licence is not justified, "then she will be subject to a lengthy period of suspension."

In handing down his sentencing decision, Belzil called it a sad situation and an egregious case. 

"All of us know our health-care system in Alberta is in crisis," the judge said. "What she did was for personal gain. 

"But what is so egregious is that the personal gain was at the expense of the health-care system and individual patients … some of whom now feel very betrayed."

Shi was given the opportunity to address the court but declined.

Family members and former patients watched as sheriffs led her away to cells.