A whistleblower with knowledge of a Medicare fraud scheme has the power to end the fraud by filing a lawsuit against the wrongdoers under the False Claims Act. Many times, such cases — also called qui tam cases — involve allegations of Medicare fraud in which a medical provider bills the public health program for services that never took place.
Health Care Fraud Scam Involved Massages and Dance Classes for Medicare Beneficiaries
Ho Yon Kim, 86, is the president of two medical clinics in Flushing, New York — Sarang Medical PC and URI Medical Service PC. Kim, a physician, also provided medical treatment at both clinics. The Department of Justice alleged that Kim, for over four years from March 2007 to October 2011, was part of a conspiracy involving supposed physical therapy and electric stimulation treatments. The treatments allegedly were not medically necessary or were never provided. Kim and his co-conspirators allegedly coaxed patients to allow the clinics to use the patients’ Medicare numbers in order to bill the health program for the sham services. In return, the Medicare patients were rewarded with lunches, dancing classes, and spa services like facials and massages. The alleged scheme ultimately added up to more than $11.7 million in fraudulent Medicare billings.
In December 2012, Kim pleaded guilty to conspiracy to commit health care fraud. The doctor’s sentencing date has not been set, but Kim could serve as many as ten years in prison for the crime.
Whistleblowers Help Fight Medicare Fraud
Instances of Medicare fraud like those at Sarang Medical PC and URI Medical Service PC in Flushing, New York often involve criminal charges filed by the government as well as civil allegations filed by a whistleblower under the False Claims Act. Frequently, Medicare fraud is uncovered when an insider blows the whistle and brings a False Claims Act lawsuit on the government’s behalf. The qui tam provisions of the Act allow whistleblowers to receive part of any amount received in settlement or in a court award.
Know your legal rights under the False Claims Act. The qui tam attorneys with Waters & Kraus can help. Call our whistleblower lawyers at 800.226.9880 or send us an email to learn more about our practice and how we can assist.