California's Division of Workers’ Compensation Suspends Three Medical
Providers for Fraud
The
Division of Workers’ Compensation (DWC) has suspended three more medical
providers from participating in California’s workers’ compensation system,
bringing the total number of providers suspended this year to 52.
DWC
Administrative Director George Parisotto issued Orders of Suspension against
the following providers:
- Byong Chun “David” Min of Irvine pled guilty on April 20, 2016 to health care fraud and illegal kickbacks. Min, co-owner and operator of Glory Rehab Team, Inc., which also operated as Dream Hospital and Daesung Clinic in Orange County, was involved in an illegal kickback scheme referring Medicare beneficiaries to co-schemers Marlon Songco, Joseff Sales and Danniel Goyena, knowing that they would bill Medicare for services that were never provided.
- Sujan Thyagaraj of Roswell, New Mexico, a physician whose medical license was summarily suspended in New Mexico in March 2016 after criminal charges were filed against him for sexual assault on a patient. The Medical Board of California revoked his physician and surgeon’s license on September 23, 2016. Thyagaraj was suspended from the Medi-Cal program on August 29, 2017.
- Rhonda Singleton of Los Angeles, owner of substance abuse treatment facility Singleton Housing Project, pled no contest in Los Angeles County Superior Court on January 25, 2017 to grand theft of the California Health Care Deposit Fund. Singleton was suspended from Medi-Cal on August 15, 2017.
AB
1244 (Gray and Daly), which went into effect January 1, introduced new changes
to the workers’ compensation system and requires the division’s Administrative
Director to suspend any medical provider, physician or practitioner from
participating in the workers’ compensation system in cases in which one or more
of the following is true:
- The provider has been convicted of a felony or misdemeanor involving fraud or abuse of the Medi-Cal or Medicare programs or the workers’ compensation system, fraud or abuse of a patient, or related types of misconduct;
- The provider has been suspended due to fraud or abuse from the Medicare or Medicaid (including Medi-Cal) programs; or
- The provider’s license or certificate to provide health care has been surrendered or revoked.
The
Department of Industrial Relation’s (DIR’s) fraud
prevention efforts are posted online, including frequently
updated lists for physicians, practitioners, and providers who have been issued
notices of suspension, and those who
have been suspended pursuant to Labor Code §139.21(a)(1).
The department recently added a new web page with information on lien consolidations and the Special Adjudication Unit.
DIR
protects and improves the health, safety and economic well-being of over 18
million wage earners, and helps their employers comply with state labor laws.
DIR’s Division
of Workers’ Compensation monitors the administration of
workers' compensation claims, and provides administrative and judicial services
to assist in resolving disputes that arise in connection with claims for
workers' compensation benefits.
================
Brea Man Who Operated Physical Therapy Clinics Sentenced to Over 10 Years in Federal Prison in $3 Million Medicare Fraud Scheme
SANTA ANA, California
– A Brea man who operated rehabilitation clinics in Walnut, Torrance
and Los Angeles and defrauded Medicare out of approximately $3 million
by billing for unneeded or unnecessary services has been sentenced to
121 months in federal prison.
Simon Hong (who is also known as Seong Wook Hong), 55, was sentenced yesterday afternoon by United States District Judge David O. Carter. At the conclusion of the sentencing hearing, Judge Carter ordered Hong remanded into custody.
Hong was found guilty in October of eight counts of healthcare fraud, nine counts of illegal kickbacks related to healthcare referrals and two counts of aggravated identity theft.
Hong owned physical therapy clinics operated by companies called Hong’s Medical Management, Inc., CMH Practice Solution, and HK Practice and Solution, Inc. As part of the scheme, Hong recruited Medicare beneficiaries and provided uncovered services like massage and acupuncture for them. Even though the beneficiaries did not receive actual physical therapy, Hong’s co-conspirators billed Medicare for physical therapy, and then funneled 56 percent of the reimbursement funds back to Hong.
Through this scheme Hong and his co-conspirators billed Medicare from the spring of 2009 until November 2013 and received approximately $2,929,775 in reimbursements, of which Hong received approximately $1,640,674. During today’s sentencing hearing, Judge Carter ordered Hong to pay $2,929,775 in restitution.
“This defendant stole nearly $3 million in federal money earmarked for those with serious medical needs,” said United States Attorney Eileen M. Decker. “This lengthy sentence accurately reflects the scope of the harm caused by the defendant to American taxpayers and legitimate Medicare beneficiaries. My office will continue to bring prosecutions against criminals causing harm to federal programs.”
Hong is one of 10 defendants who were charged in 2015 and early 2016 for healthcare fraud related to physical therapy. Eight others have pled guilty, and one, David Y. Kim, 54, of Los Angeles, remains a fugitive. Those previously convicted in the investigation are:
“Medicare provides legitimate health care services for millions of older Americans,” said Christian J. Schrank, HHS OIG Special Agent in Charge of the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG). “Fraudulently billing the program for therapies never provided will cost Mr. Hong years in prison. As this sentencing shows, not just providers, but business owners who are partners in these schemes, will pay a price. Together with our law enforcement partners, we will pursue all those involved in stealing from the Medicare trust fund.”
In a separate case, Hong pleaded guilty last month to conspiracy to commit health care fraud in another scheme involving occupational and physical therapy services that were never provided to Medicare beneficiaries. Medicare suffered losses of approximately $2.4 million in relation to this scheme. Hong is scheduled to be sentenced in this case in Los Angeles federal court by United States District Judge George Wu on March 6.
“For almost six years since May 2009, [Hong] participated in or orchestrated schemes to defraud Medicare that led to at least $5.3 million in actual losses to Medicare and potentially over $20 million in intended losses to Medicare, a program that can hardly afford them,” prosecutors wrote in a sentencing memorandum filed in relation to today’s sentencing. “He directed numerous others in executing the schemes, perverting the legitimate physical therapy services process at every turn, from patient enrollment to billing to record keeping.”
The investigation in these cases was conducted by the FBI and HHS-OIG. The prosecutions are being handled by Assistant United States Attorneys Byron J. McLain and Sarah Heidel of the Major Frauds Section.
Simon Hong (who is also known as Seong Wook Hong), 55, was sentenced yesterday afternoon by United States District Judge David O. Carter. At the conclusion of the sentencing hearing, Judge Carter ordered Hong remanded into custody.
Hong was found guilty in October of eight counts of healthcare fraud, nine counts of illegal kickbacks related to healthcare referrals and two counts of aggravated identity theft.
Hong owned physical therapy clinics operated by companies called Hong’s Medical Management, Inc., CMH Practice Solution, and HK Practice and Solution, Inc. As part of the scheme, Hong recruited Medicare beneficiaries and provided uncovered services like massage and acupuncture for them. Even though the beneficiaries did not receive actual physical therapy, Hong’s co-conspirators billed Medicare for physical therapy, and then funneled 56 percent of the reimbursement funds back to Hong.
Through this scheme Hong and his co-conspirators billed Medicare from the spring of 2009 until November 2013 and received approximately $2,929,775 in reimbursements, of which Hong received approximately $1,640,674. During today’s sentencing hearing, Judge Carter ordered Hong to pay $2,929,775 in restitution.
“This defendant stole nearly $3 million in federal money earmarked for those with serious medical needs,” said United States Attorney Eileen M. Decker. “This lengthy sentence accurately reflects the scope of the harm caused by the defendant to American taxpayers and legitimate Medicare beneficiaries. My office will continue to bring prosecutions against criminals causing harm to federal programs.”
Hong is one of 10 defendants who were charged in 2015 and early 2016 for healthcare fraud related to physical therapy. Eight others have pled guilty, and one, David Y. Kim, 54, of Los Angeles, remains a fugitive. Those previously convicted in the investigation are:
-
Joseff Sales, 39, of Buena Park, a co-owner and operator of Rehab
Dynamics, who pleaded guilty to one count of healthcare fraud and one
count of illegal kickbacks, and was sentenced last year to 51 months in
prison;
-
Danniel Goyena, 39, of Buena Park, a co-owner and operator of Rehab
Dynamics, who pleaded guilty to two counts of healthcare fraud and was
sentenced last year to 51 months in prison;
-
Marlon Sonco, 39, of Sylmar, who pleaded guilty in June 2015 to conspiracy and is scheduled to be sentenced on January 23;
-
Eddieson Legaspi, 40, of Lomita, an employee of Rehab Dynamics,
pleaded guilty to conspiracy to commit healthcare fraud and also was
sentenced yesterday to 15 months;
-
Ohun Kwon, 50, of Fullerton, the owner/operator of E.K. Medical
Management, which referred patients to Rehab Dynamics, pleaded guilty to
conspiracy to commit healthcare fraud and was sentenced last year to 27
months in federal prison;
-
Leovigildo Sayat, 39, of Torrance, an employee of RSG Rehab, pleaded
guilty to conspiracy to commit health care fraud and was sentenced last
year to two years in prison;
-
Byong Chun “David” Min, 68, of Irvine, co-owner/operator of Glory
Rehab Team, which operated as Dream Hospital in Orange County, who
pleaded guilty to healthcare fraud and illegal kickbacks, also was
sentenced yesterday to 45 months in prison; and
-
Jason S. Min, 35, of Irvine, David Min’s son, who was the other
owner/operator of Glory Rehab, pleaded guilty last year to obstruction
of justice and is scheduled to be sentenced on February 6.
“Medicare provides legitimate health care services for millions of older Americans,” said Christian J. Schrank, HHS OIG Special Agent in Charge of the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG). “Fraudulently billing the program for therapies never provided will cost Mr. Hong years in prison. As this sentencing shows, not just providers, but business owners who are partners in these schemes, will pay a price. Together with our law enforcement partners, we will pursue all those involved in stealing from the Medicare trust fund.”
In a separate case, Hong pleaded guilty last month to conspiracy to commit health care fraud in another scheme involving occupational and physical therapy services that were never provided to Medicare beneficiaries. Medicare suffered losses of approximately $2.4 million in relation to this scheme. Hong is scheduled to be sentenced in this case in Los Angeles federal court by United States District Judge George Wu on March 6.
“For almost six years since May 2009, [Hong] participated in or orchestrated schemes to defraud Medicare that led to at least $5.3 million in actual losses to Medicare and potentially over $20 million in intended losses to Medicare, a program that can hardly afford them,” prosecutors wrote in a sentencing memorandum filed in relation to today’s sentencing. “He directed numerous others in executing the schemes, perverting the legitimate physical therapy services process at every turn, from patient enrollment to billing to record keeping.”
The investigation in these cases was conducted by the FBI and HHS-OIG. The prosecutions are being handled by Assistant United States Attorneys Byron J. McLain and Sarah Heidel of the Major Frauds Section.