Korean nurse who defrauded Medicare gets 57 months in prison

July 28, 2014

(CNS) – A registered nurse who owned a home healthcare agency in the Westlake district of Los Angeles was sentenced today to 57 months in federal prison and ordered to pay restitution of about $5.1 million for a fraud scheme involving kickbacks to doctors and patients who did not qualify for in-home services.

Hee Jung“Angela” Mun, 52, of Rancho Palos Verdes pleaded guilty in 2012 to federal health care fraud charges stemming from the scheme that targeted elderly, primarily Korean, Medicare beneficiaries, according to federal prosecutors.

Mun owned Greatcare Home Health Inc., which was shut down in March 2011 when special agents with the FBI and other agencies executed a search warrant at the company’s office.

The case came to light in March 2010 when the clinic’s receptionist filed a lawsuit on behalf of the U.S. government naming as defendants Greatcare; Mun, the company’s owner/director; three physicians; a physical therapist and several licensed nurses; and other unlicensed persons employed by the agency.

In a plea agreement filed in Los Angeles federal court, Mun admitted that she orchestrated the scheme that defrauded Medicare by paying illegal kickbacks to doctors for patient referrals, to “cappers” or “marketers” for patient referrals, and to patients to induce them to sign up for home health services.

She also admitted billing Medicare for patients who were not homebound or who otherwise did not quality for home health services, and for services provided by unlicensed individuals or not provided at all; creating bogus medical records to support fraudulent claims to Medicare; and “upcoding” or exaggerating patient conditions to generate larger reimbursements from Medicare.

Two others involved in the scheme previously pleaded guilty to health care fraud charges. Seonweon Kim, 48, of Arcadia, and Jung Sook Lee, 53, of Koreatown, are expected to be sentenced in October.

As part of the investigation, authorities seized $1.2 million from Greatcare bank accounts, prosecutors said.