Eight federal arrests were made in Los Angeles, California pertaining to $50 million of national health care fraud – including one case involving immigration law violations, the U.S. Justice Department reported Thursday.
The U.S. Attorney's Office for the Central District of California details the law enforcement sweep, which included the Federal Bureau of Investigation (FBI), in an announcement:
“In coordination with the Vice President’s Task Force to Eliminate Fraud, eight defendants, including three nurses, a chiropractor, and a psychologist, have been arrested on federal charges that they schemed to defraud the nation’s health care system out of more than $50 million – including by running sham hospice care facilities that bilked Medicare by using people without terminal illnesses as beneficiaries.”
Alleged crimes committed by those charged include:
- Using their own or their accomplices’ companies to submit millions of dollars of fraudulent hospice claims to Medicare.
- Billing Medicare for hospice services for beneficiaries who were not terminally ill.
- Scheming to defraud Medicare by paying illegal kickbacks for the referral of patients who were not dying to hospices.
- Operating fraudulent hospice care facilities – in one case, while the suspect was free on bond awaiting a hospice fraud trial.
- Committing wire fraud.
- Submitting false claims to Medicare for physician hospice services that were not provided to patients.
- Forging the signature of a physician on Medicare enrollment forms.
- Using a co-conspirator’s name and ID number to file fraudulent claims, in exchange for a portion of the proceeds.
Some of the hospices had non-death discharge rates that were nearly five times higher than the national average, suggesting that many of those taken into care were not actually terminally-ill, as claimed.
Additionally, money that was paid to provide patient care was actually used for personal expenses such as mortgage payments, car payments, international flights, restaurants, and personal bills.
In the case of immigration health care fraud, Young Joo Ko, 59, of East Hollywood and a lawful permanent resident from South Korea, was arrested on a federal criminal complaint charging her with fraud and misuse of visas, permits, and other documents.
According to an affidavit filed with the complaint, Ko engaged in a medical fraud scheme exploiting the green card application process by creating fraudulent immigration documents.
Civil surgeons designated by U.S. Citizenship and Immigration Services (USCIS) and operating in the Los Angeles area did not examine green card applicants as required by law.
Instead, Ko – for a fee – fraudulently prepared the required forms by presenting herself as a nurse or doctor and indicating false compliance with medical examination requirements necessary for immigration applicants to register permanent residence or adjust their immigration status, according to allegations.
Homeland Security Investigations (HIS), IRS Criminal Investigation, and United States Citizenship and Immigration Services (USCIS) are investigating this matter.
