A federal jury found a southern California doctor guilty for his role in a $12 million scheme to provide medically unnecessary procedures to Medicare beneficiaries, upcode claims submitted to Medicare, and re-package single-use catheters for reuse on patients.
After a six-day trial, Donald Woo Lee, 54, of Temecula, California, was found guilty of seven counts of health care fraud and one count of adulteration of a medical device. Sentencing has been scheduled for March 19, 2020, before U.S. District Judge George Wu of the Central District of California, who presided over the trial.
According to evidence presented at trial, from 2012 to 2015, Lee engaged in a scheme in which he recruited Medicare beneficiaries to his clinics, falsely diagnosed the beneficiaries with venous insufficiency and provided the beneficiaries with medically unnecessary vein ablation procedures. The evidence further established that 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 repackaged used, contaminated catheters for re-use on patients. These catheters had been cleared by the FDA for marketing as single-use only. Lee submitted claims of approximately $12 million to Medicare for the vein ablation procedures he performed, and received $4.5 million as a result, the evidence showed.