Doctor convicted of $12M Medicare fraud in LA federal court

A Temecula doctor has been found guilty after a six-day trial in federal court in Los Angeles for $12 million in fraudulent bills submitted to Medicare, according to an announcement Thursday from U.S. Attorney Nicola T. Hanna of the Central District.

Dr. Donald Woo Lee was one of 301 people arrested in a nationwide health fraud crackdown in 2016. He was convicted of seven counts of health care fraud, which netted him $4.5 million in payments, along with one count of adulterating a medical device. He potentially faces decades in prison and more than $1 million in fines at his sentencing March 19. U.S. v. Lee, CR16-0415 (C.D. Cal., filed Aug. 16, 2016).

The investigation was led by the Medicare Fraud Strike Force under the federal Department of Health and Human Services Office of the Inspector General.

Prosecutors said Lee recruited Medicare patients to his clinic, gave them fraudulent diagnoses and performed "unnecessary vein ablation procedures." They said Lee then submitted false invoices using the wrong code in an effort to increase his reimbursement, a scheme known as "upcoding." Finally, he was accused of reusing catheters only approved by the Food and Drug Administration for a single use, exposing patients to possible infection.

According to a press release Thursday from the U.S. Department of Justice, since its creation in 2007 the Medicare Fraud Strike Force has charged 4,200 people with attempting to bilk the system of $19 billion. The FBI and the U.S. Food and Drug Administration Office of Criminal Investigations' also participated in the operation that led to Lee's arrest. U.S. District Judge oversaw the trial.

-- Malcolm Maclachlan