Five people tied to a $5 million health care fraud scheme–which recruited elderly Koreans in Southern California to pose as patients–have received federal prison sentences the past couple weeks, while two more defendants learn their fates in October.
But an eighth participant in the scam, and the only one who resided in Orange County, remains a fugitive.
Fullerton's Ji Hae Kim, a 43-year-old registered nurse, pleaded guilty in federal court in Los Angeles to conspiracy to commit health-care fraud in November 2011 but skipped while awaiting sentencing, according to U.S. Department of Health and Human Services investigators who believe she may be in South Korea.
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Kim worked with Greatcare Home Health Inc., a home health agency based in the Westlake area of Los Angeles that federal agents shut down in March 2011 after an investigation by the FBI and U.S. Department of Health and Human Services' Office of the Inspector General.
Medicare paid Greatcare about $5.1 million for home health services to patients, but the reimbursements were based on false forms Kim prepared. The forms made it appear patients' medical conditions and lack of willing caregivers made them eligible for home health services. She also falsified daily route sheets and skilled nursing notes to make it appear as though she had visited patients whom she had never visited.
Just this week, another Greatcare registered nurse was sentenced to 57 months in federal prison for her role in the scam. Hee Jung Mun, who often used the name Angela Mun, had pleaded guilty as part of a plea deal in 2012. The 52-year-old Rancho Palos Verdes resident paid illegal kickbacks to doctors, patients and those known as “cappers” or “marketers” who recruited patients. She also billed Medicare for patients who were not homebound, did not qualify for services, were seen by unlicensed representatives or who never received services at all.
In addition to the prison time, U.S. District Court Judge Dean D. Pregerson ordered Mun to pay $5.144 million in restitution to Medicare. Authorities previously seized $1.2 million from the bank accounts of Mun and GreatCare.
Another federal judge already ordered Mun to pay nearly $15 million to resolve a “whistleblower” lawsuit associated with the scheme and brought by a GreatCare employee.
Others who have received sentences in the case(s) are:
* Sang Whan Ahn, 60, of Koreatown, who recruited many of GreatCare's Medicare beneficiaries in exchange for illegal kickbacks. Ahn was sentenced to four months in prison;
* Dr. Whan Sil Kim, also known as “Victoria,” received illegal kickbacks for health-care referrals. The 71-year-old Hancock Park resident was sentenced to a year and a day in prison. She was separately ordered to pay $1.088 million in the whistleblower suit;
* GreatCare nurses Hwa Ja Kim, also known as “Helen,” was sentenced to 18 months in prison. The Harbor City 70-year-old signed off on patient evaluations and visits she did not do;
* Yeong Ja Lee, 52, of Mid-City, was one of the unlicensed individuals Greatcare used to see patients and create fake paperwork. Lee was sentenced to 15 months in prison.
Physical therapist Seonweon Kim, 48, of Arcadia, is scheduled to be sentenced on Oct. 6
in connection with the scam and already agreed to pay $205,000 in the lawsuit.
GreatCare employee Jung Sook Lee, 53, of Koreatown, is to be sentenced on Oct. 20 for the scam.
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 the company.
Email: mc****@oc******.com. Twitter: @MatthewTCoker. Follow OC Weekly on Twitter @ocweekly or on Facebook!
OC Weekly Editor-in-Chief Matt Coker has been engaging, enraging and entertaining readers of newspapers, magazines and websites for decades. He spent the first 13 years of his career in journalism at daily newspapers before “graduating” to OC Weekly in 1995 as the alternative newsweekly’s first calendar editor.