Owner of Home Health Agency Sentenced to Nearly Five Years for Bilking Medicare out of $5 Million in Health Care Fraud Scheme
LOS ANGELES – A registered nurse who operated GreatCare Home Health, Inc., a home health agency based in the Westlake district of Los Angeles, has been sentenced to 57 months in federal prison for orchestrating a $5 million Medicare fraud scheme involving kickbacks to doctors and patients who did not qualify for in-home health services provided by GreatCare.
Hee Jung Mun, who often used the name Angela Mun, 52, of Rancho Palos Verdes, was sentenced late yesterday by United States District Judge Dean D. Pregerson. 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 the scheme (see: http://www.justice.gov/usao/cac/Pressroom/2013/116.html).
Mun pleaded guilty in 2012 and admitted orchestrating a three-year scheme to defraud Medicare. In her plea agreement, Mun admitted that she bilked 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 Mun was the leader of the scheme, seven other defendants have been convicted in related cases for their roles in the Greatcare fraud:
shortly after Mun’s sentencing yesterday, Sang Whan Ahn, 60, of Koreatown, who recruited many of GreatCare’s Medicare beneficiaries in exchange for illegal kickbacks, was sentenced to four months in prison;
doctor Whan Sil Kim, also known as “Victoria,” 71, of Hancock Park, was sentenced to a year and a day in prison for receiving illegal kickbacks for health care referrals;
one of GreatCare’s nurses, Hwa Ja Kim, also known as “Helen,” 70, of Harbor City, was sentenced to 18 months in prison for signing off on patient evaluations and visits she did not do;
Yeong Ja Lee, 52, of Mid-City, one of the unlicensed individuals Greatcare used to see patients and create fake paperwork, was sentenced to 15 months in prison just last week;
physical therapist Seonweon Kim, 48, of Arcadia, is scheduled to be sentenced on October 6; and
GreatCare employee Jung Sook Lee, 53, of Koreatown is scheduled to be sentenced on October 20.
An eighth defendant in the case, Registered nurse Ji Hae Kim, 43, of Fullerton, is a fugitive.
“Home health scams and the payment of illegal kickbacks to physicians remain serious problems in the Los Angeles area, costing taxpayers millions of dollars,” said Glenn R. Ferry, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General’s (OIG) Los Angeles Region. “Home health remains a top oversight priority for OIG, and we will continue to work with our law enforcement partners to aggressively investigate and prosecute anyone who engages in home health fraud.”
In a related “whistleblower” lawsuit brought by one of GreatCare’s former employees, 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.
Dr. Kim has agreed to pay $1.088 million as a part of a consent judgment for her conduct, while Seonweon Kim has agreed to pay $205,000 to resolve his civil liability related to GreatCare.
The investigation into GreatCare was conducted by the Federal Bureau of Investigation and United States Department of Health and Human Services, Office of the Inspector General.
Release No. 14-098
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