Dive Brief:
- A federal jury on Wednesday found a southern California doctor guilty for his role in a scheme to repackage single-use catheters so they could be reused on patients. He was also found guilty of upcoding Medicare claims and providing unnecessary medical procedures for Medicare beneficiaries.
- The guilty verdict for Donald Woo Lee of Temecula, Calif., came after a six-day trial. Woo, 54, was found guilty of one count of adulterating a medical device and seven counts of healthcare fraud.
- Sentencing is set to take place next March before Judge George Wu of the U.S. District Court for the Central District of California.
Dive Insight:
The case against Lee was brought as part of the strike force under the supervision of the Justice Department's Criminal Division Fraud section and the U.S. Attorney's Office for the Central District of California.
The case involved a three-year scheme in which Lee recruited Medicare beneficiaries to his clinics, falsely diagnosed them with venous insufficiency and medically unwarranted vein ablation procedures were performed on them. In connection with those procedures, he submitted inappropriately coded claims to Medicare to obtain higher reimbursement. Lee also repackaged used contaminated catheters to reuse on patients despite the catheters having been cleared by FDA for single-use only.
Evidence showed Lee submitted approximately $12 million worth of claims to Medicare for the medically unnecessary procedures and pocketed $4.5 million from those procedures.
The federal government is ramping up its efforts to go after healthcare fraud in government programs. The Medicare Fraud Strike Force is central to those efforts.
Created in 2007, the Medicare Fraud Strike Force has units operating in 23 districts and has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. It's a joint effort between DOJ and HHS.
According to the most recent statistics from January, the strike force has brought 2,117 criminal actions, secured 2,754 indictments and recovered $3.3 billion in connection with its investigations.
