On
July 29, 2014, U.S. District Judge Dean D. Pregerson sentenced a registered
nurse, Hee (“Angela”) Jung Mun, who operated GreatCare Home Health, Inc., a
home health agency to 57 months in federal prison. In addition to the prison
term, Judge Pregerson also ordered Mun to pay $5.144 million in restitution to
Medicare. As part of the investigation, authorities previously seized $1.2
million from bank accounts owned by Mun and GreatCare. Another federal judge
ordered Mun to pay nearly $15 million to resolve a “whistleblower” lawsuit
associated with this case.
Ms.
Mun pleaded guilty in 2012 and admitted orchestrating a three-year scheme to
defraud Medicare. In her plea agreement, Ms. Mun admitted that she defrauded
Medicare out of millions by:
(1)
paying illegal kickbacks to doctors and individuals known as “cappers” or
“marketers” for patient referrals, and to patients themselves to sign up for
home health services,
(2)
billing Medicare for patients who were not homebound or who otherwise did not
quality for home health services, and
(3)
billing Medicare for services provided by unlicensed individuals or not
provided at all.
The
scheme targeted elderly, primarily Korean, Medicare beneficiaries. GreatCare
was shut down by federal agents after the execution of a search warrant there
in March 2011.
While
Ms. Mun was the alleged leader, seven other defendants have been convicted in
related cases for their roles in the Greatcare fraud case - four of whom have already
been sentenced:
(1) Sang
Whan Ahn, 60, who recruited many of GreatCare’s Medicare beneficiaries in
exchange for illegal kickbacks, was sentenced to four months in prison;
(2) Doctor
Whan Sil Kim, also known as “Victoria,” 71, was sentenced to a year and a day
in prison for receiving illegal kickbacks for health care referrals;
(3) One
of GreatCare’s nurses, Hwa Ja Kim, also known as “Helen,” 70, was sentenced to
18 months in prison for signing off on patient evaluations and visits she did
not do;
(4) Yeong
Ja Lee, 52, one of the unlicensed individuals Greatcare used to see patients
and create fake paperwork, was sentenced to 15 months in prison just last week;
(5) Physical
therapist Seonweon Kim, 48, is scheduled to be sentenced on October 6;
(6) GreatCare
employee Jung Sook Lee, 53, is scheduled to be sentenced on October 20; and
(7) Registered nurse Ji Hae Kim, 43, is a fugitive.
Attorney Commentary:
In
a related “whistleblower” qui tam lawsuit brought in March 2010 by one of GreatCare’s former receptionists, two other GreatCare referring doctors, Dr. Dong Shin and Dr. Bo W.
Paik, agreed to pay $217,810 and $530,000, respectively, to resolve allegations
that they received cash payments and patient referrals in exchange for
referring Medicare beneficiaries to GreatCare and signing false certificates of medical necessity. The government did not intervene in this case but participated in the settlement negotiations. Dr. Shin has paid $150,000 and is to make monthly payments.
Defendant Dr. Kim has agreed to pay $1.088
million as a part of a consent judgment for her conduct, while Defendant Seonweon Kim has
agreed to pay $205,000 to resolve his civil liability related to GreatCare. Defendant Mun defaulted in the case and has over a $14 million default judgment entered against her.
The sentences in these cases are lengthy in large part because of the large amount of Medicare billings (in excess of $5 million) and the defendants are charged in conspiracy counts where they are held responsible for the entire billings even where they did not collect the amounts billed or were paid salaries. In this case, the search warrant was executed in March 2011 and there
Posted
by Tracy Green, Esq.
Email:
tgreen@greenassoc.com
Phone:
213-233-2260
Green
and Associates, Attorneys at Law
