A California doctor was sentenced to 93 months in prison for defrauding Medicare, re-packaging single-use catheters for re-use on patients, and submitting false declarations in a bankruptcy proceeding.
On June 6, 2016, Donald Woo Lee, 55, of Temecula, California, was charged with seven counts of health care fraud in an indictment returned by a federal grand jury in the Central District of California. Lee was additionally charged with one count of adulteration of a medical device and one count of false statements in bankruptcy in a subsequent superseding indictment filed on June 7, 2018.
Lee was an internal medicine doctor who owned, operated, and oversaw several medical clinics in the greater Los Angeles and Riverside areas. He was a 1994 graduate of St. George’s University in Grenada, His medical license in California was surrendered on November 7, 2019 after disciplinary charges were filed against him.
According to court documents, Lee recruited Medicare beneficiaries to his clinics, falsely diagnosed the beneficiaries, and provided the beneficiaries with medically unnecessary procedures. Lee billed these unnecessary procedures to Medicare using an inappropriate code in order to obtain a higher reimbursement, a practice known as “upcoding.”
In addition, the evidence showed that Lee re-packaged used, contaminated catheters for re-use on patients. These catheters had been cleared by the Food and Drug Administration (FDA) for marketing as single-use only and the re-use of these devices put patients at risk of infection and other bodily injury. Lee submitted claims of approximately $12 million to Medicare for the vein ablation procedures he performed, and received $4.5 million as a result.
In October 2019, Lee was convicted after a five-day trial, when a jury found him guilty of seven counts of health care fraud and one count of adulteration of a medical device. Lee also pleaded guilty on March 2, 2020, to one count of submitting false declarations in a bankruptcy proceeding.
In addition to the term of imprisonment, Lee was sentenced to serve three years of supervised release and ordered to pay more than $4.5 million in restitution to Medicare.
Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.