United States v. Donald Woo Lee

PENDING CRIMINAL DIVISION CASES

United States v. Donald Woo Lee
Court Docket No.: 2:16-cr-00415 (C.D. California)

Court Assigned: This case is assigned to U.S. District Judge George H. Wu, U.S. District Court for the Central District of California, Courtroom 9D, U.S. Courthouse, 350 West 1st Street, Los Angeles, CA, 90012. Unless otherwise noted in an update below, all court events will take place at this location.

Latest Update – On May 6, 2024, Judge George H Wu reduced defendant Donald Woo Lee’s sentence of 93 months of imprisonment to 87 months based on changes to the U.S. Sentencing Guidelines. In addition, Lee is ordered to pay a special assessment of $900 and restitution in the amount of $4,587,533.79 to Medicare.

Criminal Charges: 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. On October 16, 2019, following a jury trial, Lee was found guilty on the health care fraud and adulteration counts.  On March 2, 2020, Lee pleaded guilty to the false statements in bankruptcy count.

Lee was an internal medicine doctor who owned, operated, and oversaw several medical clinics in the greater Los Angeles and Riverside areas.

Beginning in or around 2012, Lee started submitting claims to Medicare for vein ablation procedures, a treatment for venous insufficiency.

Medicare reimburses providers for vein ablation procedures in certain circumstances only: the patient must have varicose veins with specific symptoms, including ulcers, significant pain or swelling that interferes with the activities of daily living, bleeding associated with diseased vessels, or inflammation; the patient must have undergone a 6 to 8 week period of conservative treatment, including weight loss, compression stockings, leg elevation, and exercise; and at the end of the conservative care period the patient must remain symptomatic. If the symptoms were not present and documented, and if the conservative treatment period was not followed and documented, then Medicare would not consider the vein ablation procedure to be medically necessary and would not reimburse medical providers for the vein ablation claim they submitted.  

Beginning in or around September 2012, Lee began falsely representing to Medicare patients that they needed vein ablation procedures when the patients had no visible signs of varicose veins, no adverse symptoms, no ultrasound images diagnostic of venous insufficiency, and therefore no medical need for vein ablation. Lee performed the vein ablation procedures without ordering conservative treatment for the 6 to 8 weeks required by Medicare and despite the fact that the patients did not display the symptoms required for Medicare to consider the procedures medically necessary. Evidence at trial further established that Lee repackaged used vein ablation “ClariVein” catheters for reuse on patients, even though he knew that the catheters were FDA approved for single use only.

In carrying out his scheme to bill Medicare for unnecessary vein ablation procedures, Lee also engaged in “upcoding,” in which he deliberately used the wrong billing code for vein ablation procedures in order to receive a higher reimbursement from Medicare. Medicare claims data demonstrates that between August 2012 and August 2015, Lee billed Medicare $12,476,350 for vein ablation and related procedures, and was paid $4,587,533.79 by Medicare for those procedures.

For more information about the charges, please see below:
Indictment
Superseding Indictment

Presumption of Innocence: It is important to keep in mind that an Indictment contains allegations only, and that defendants are presumed innocent until proven guilty.  That presumption requires both the court and our office to take certain steps to ensure that justice is served.

Crime Victims’ Rights Act and Right to Retain Counsel: The Crime Victims’ Rights Act (18 U.S.C. § 3771) applies only to victims of the counts charged in federal court, and thus individuals may not be able to exercise all of these rights if the crime of which the individual is a victim was not charged. Section 3771(c)(2) of this Act requires that we advise you that you have the right to retain counsel. Although the statute specifically sets forth your right to seek advice of an attorney with regard to your rights under the statute, there is no requirement that you retain counsel. The Government may not recommend any specific counsel, nor can the government (or the court) pay for counsel to represent you. Government attorneys represent the United States.

If you elect to obtain counsel to represent your interests, please have your attorney notify this office in writing at: U.S. Department of Justice, Criminal Division, Fraud Section, 10th & Constitution Avenue, NW, Bond Building, 4th Floor, Washington, DC 20530, Attention: Victim Witness Unit; fax: (202) 514-3708; or email: VictimAssistance.fraud@usdoj.gov. If you elect not to retain counsel to represent your interests, you do not need to do anything.