Thursday, July 31, 2014

Owner Of Los Angeles Home Health Agency Sentenced To Nearly Five Years For Health Care Fraud Case Involving Kickbacks to Doctors and Medicare Patients Who Did Not Qualify for In-Home Health Services. Related Qui Tam Lawsuit Settled.

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.
Phone: 213-233-2260

Green and Associates, Attorneys at Law


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