Owner Of Home Health Agency That Defrauded Medicare Ordered To Pay $14.9 Million – Three Times The Losses Caused By Scheme

LOS ANGELES – A federal judge has ordered the owner of a home health agency that operated in the Westlake District of Los Angeles to pay nearly $15 million – or approximately three times the losses suffered by Medicare as a result of the company’s illegal practices.

United States District Judge Stephen V. Wilson previously issued a $14,902,832 default judgment against Hee Jung Mun, the former owner and operator of GreatCare Home Health Agency, who was commonly known as Angela Mun. The judgment resolves a “whistleblower” lawsuit filed by GreatCare’s receptionist.

The judgment against Mun and the conclusion of the whistleblower lawsuit was announced today when the U.S. Marshals service transferred to the United States Treasury $1,297,958 that was seized in March 2011 when federal agents executed a search warrant at GreatCare and executed seizure warrants on GreatCare’s and Mun’s bank accounts.

GreatCare paid kickbacks to physicians and others to induce them to refer patients to GreatCare in a $5 million Medicare fraud scheme.

In January 2012, Mun pleaded guilty to healthcare fraud charges for her central role in a scheme that paid kickbacks to physicians and marketers who referred patients to GreatCare (see: http://www.justice.gov/archive/usao/cac/Pressroom/2012/008.html). As part of the scheme, Medicare beneficiaries were also paid to sign up for GreatCare’s service, even though many of them were not eligible for home health services. GreatCare billed Medicare for services that were not rendered, were unnecessary, and/or were performed by unlicensed personnel. Mun is currently scheduled to be sentenced in February.

In June, one of the physicians who received kickbacks for referring patients to GreatCare and signed false certificates of medical necessity – Dr. Dong Shin – agreed to pay the United States $217,810 to resolve his civil liability for his role in the scheme.   The settlement amount was based upon Dr. Shin’s assessed ability to pay. Shin has paid $150,000 and has agreed to make monthly payments until the balance is paid off.

Also in June, Seonweon Kim, a physical therapist at GreatCare, agreed to pay the United States $205,000 to resolve his civil liability for his participation in the scheme. Kim pleaded guilty last year to healthcare fraud and admitted that he created false physical therapy notes that falsely indicated he had provided various services to patients. Kim is also scheduled to be sentenced early next year. Kim has already paid  $85,000 of the settlement amount; the remainder will be paid in monthly installments.

Another referring physician, Dr. Whan Sil Kim, pleaded guilty to receiving kickbacks and was sentenced last year to one year and one day in prison. In March, the Court entered a consent judgment against Dr. Kim pursuant to which she agreed to pay the United States $1,088,799 to resolve her liability in the civil action.

The judgment against Mun – which was filed by Judge Wilson on July 23 – and the settlements resolve the civil lawsuit United States ex rel. Kim v. GreatCare Home Health Agency, et al., a “whistleblower” lawsuit that alleged GreatCare billed Medicare for thousands of home health visits that were not rendered and/or were medically unnecessary. The lawsuit further alleged that GreatCare executed the scheme by recruiting Medicare beneficiaries and paying kickbacks to the beneficiaries and to doctors to induce referrals for home health services.

The Medicare fraud scheme came to light in March 2010 when GreatCare’s then-receptionist, Misha Kim, filed the qui tam lawsuit under the federal False Claims Act. United States District Judge Stephen V. Wilson unsealed the whistleblower lawsuit in October 2011. The United States did not intervene in the lawsuit, but actively participated in settlement negotiations and coordinated extensively with Relator’s counsel in bringing this case to completion.

The civil case was investigated by the Federal Bureau of Investigation and the Office of Inspector General of the U.S. Department of Health & Human Services.

Release No. 13-116