- Created on Friday, 14 December 2012 22:14
- Written by IVN
Los Angeles, California - A Los Angeles physician who received approximately $30,000 in illegal kickbacks as part of a scheme that defrauded Medicare out of more than $5 million has been sentenced to one year and one day in federal prison.
Whan Sil Kim, also known as “Victoria Kim,” a 69-year-old Hancock Park resident, was sentenced yesterday afternoon by United States District Court Judge Dean D. Pregerson. In addition to the prison term, which Kim was ordered to begin serving by February 13, 2013, Judge Pregerson ordered the defendant to pay $1.088 million in restitution to Medicare.
Kim pleaded guilty in July 2012 to receiving illegal remunerations related to health care referrals, admitting that she fraudulently referred Medicare beneficiaries to Greatcare Home Health Inc. in return for kickbacks. Between May 2008 and early 2011, Kim had an arrangement under which she would see—but not examine—Medicare beneficiaries at Greatcare’s clinic in the Westlake District of Los Angeles. After meeting with the Medicare beneficiaries after GreatCare’s normal business hours, Kim wrote referrals for home health services. Kim received $100 for each referral. As a part of the scheme, Kim also signed off on plans of care for the beneficiaries, falsely representing that the patients were under her care, confined to the home without a willing caregiver, and had a medical necessity for home health services. The scheme targeted elderly, primarily Korean, Medicare beneficiaries.
All of Kim’s referrals went to GreatCare and ultimately led to $1.088 million in losses to Medicare on the fraudulent claims. In total, Kim’s referrals and referrals from other doctors to Greatcare resulted in more than $5 million in losses to Medicare.
Greatcare was shut down in March 2011 when special agents with the Federal Bureau of Investigation (FBI) and the Department of Health and Human Services-Office of Inspector General (HHS-OIG) executed a search warrant and seized $1.2 million from Greatcare bank accounts. The criminal investigation into Greatcare was prompted by a still-pending “whistleblower” lawsuit filed by a former employee. As a part of the criminal investigation, Kim received a subpoena for patient files, but she created fake patient files that falsely made it appear as though Kim had examined and properly referred the patients for home health services.
Kim, who used to practice at clinics in Mid-Wilshire, Studio City, and Irvine, has since surrendered her medical license and is subject to mandatory exclusion from billing Medicare.
Greatcare’s owner—Hee Jung Mun, who often used the name “Angela,” 50, of Rancho Palos Verdes—and other Greatcare employees, including registered nurses Ji Hae Kim, 43, of Fullerton, and Hwa Ja Kim, 68, of Harbor City, have entered guilty pleas and are currently awaiting sentencing.
The Greatcare investigation was conducted by members of the Medicare Fraud Strike Force from the FBI and HHS-OIG. Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.