LOS ANGELES – A registered nurse who operated GreatCare Home Health, Inc., a home health agency based in the Westlake district of Los Angeles, was sentenced on Monday to nearly five years in federal prison for Medicare fraud, officials said.
Hee Jung Mun admitted to masterminding a $5 million Medicare fraud scheme involving kickbacks to doctors and patients who didn’t qualify for in-home health services provided by GreatCare, officials said.
U.S. District Court Judge Dean D. Pregerso also ordered Mun, who often used the name Angela Mun, 52, of Rancho Palos Verdes, to pay $5.1 million as restitution to Medicare. 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. Mun pleaded guilty in 2012 and admitted concocting a three-year scheme to defraud Medicare.
“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.”
The FBI and the U.S. Department of Health and Human Services conducted the investigation into GreatCare.
In her plea agreement, Mun admitted that she bilked Medicare out of millions by doing the following:
- 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.
- Billing for patients who were not homebound or who otherwise did not quality for home health services.
- Billing 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 at the facility 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:
- 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.
- Dr. 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.
- GreatCare’s nurse 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 at Greatcare, used to see patients and create fake paperwork, was sentenced to 15 months in prison last week.
- Physical therapist Seonweon Kim, 48, of Arcadia, and GreatCare employee Jung Sook Lee, 53, of Koreatown are scheduled to be sentenced in October.
- An eighth defendant in the case, Registered nurse Ji Hae Kim, 43, of Fullerton, is a fugitive.
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.