Queens Adult Day Care and Pharmacy Medicare & Medicaid Fraud Charges in $120M Scheme

Federal prosecutors in the Eastern District of New York have unsealed a complaint charging Inwoo Kim and Daniel Lee, two men from Queens, with operating a major Medicare and Medicaid fraud scheme that allegedly siphoned approximately $120 million from taxpayer-funded health programs. According to the Department of Justice announcement, the defendants used ownership of a pharmacy and two social adult day care centers, Royal Adult Daycare and Happy Life, as fronts to bill federal healthcare programs for medically unnecessary or nonexistent prescription drugs and social adult day care services.

Prosecutors allege that Kim and Lee paid illegal kickbacks in the form of cash and supermarket gift cards to Medicare beneficiaries and Medicaid recipients to induce them to fill prescriptions at the pharmacy and enroll in the adult day care facilities. The complaint also contends that both men submitted claims for services beyond the permitted capacity of the centers and used significant cash withdrawals to fund the pay-offs. If convicted of conspiracy to commit health care fraud, the defendants face up to ten (10) years in prison for each count. The case highlights the ongoing threat posed by fraudulent billing schemes that exploit vulnerable populations and drain federal health care dollars.