New Jersey Doctor Convicted of Medicare Fraud in $5.4 Million Orthotics Scheme

BACK TO INSIGHTS     Articles

6/30/2024

On April 26, 2024, the U.S. Department of Justice announced that a New Jersey doctor was convicted on three counts of health care fraud and two counts of making false statements related to health care. The doctor was found guilty of causing over $5.4 million in fraudulent claims for orthotic braces ordered through a telemarketing scheme to be paid by Medicare.

In furtherance of the scheme, the doctor prescribed orthotic braces after brief telephone conversations with beneficiaries. For example, he prescribed multiple braces, including a back brace, shoulder brace, wrist brace, and knee brace, to an undercover agent after a call lasting just over a minute. In another case, he prescribed a knee brace to a Medicare beneficiary who had previously had both legs amputated. Evidence presented at trial showed that the doctor could not have diagnosed the beneficiaries or determined the medical necessity of the braces during these brief calls. Despite this, he signed prescriptions falsely indicating that the braces were medically necessary, that he had diagnosed the beneficiaries, had a plan of care for them, and recommended additional treatment. Brace supply companies then used these false prescriptions to bill Medicare more than $5.4 million.

The doctor is scheduled for sentencing on October 8, 2024 and faces a maximum penalty of 10 years in prison for each health care fraud count and five years in prison for each false statement count.

Click Here to read the entire June 2024 Healthcare Law Update now!

For more information, contact:
John D. Fanburg, Chair | 973.403.3107 | jfanburg@bracheichler.com
Edward Hilzenrath | 973.403.3114 | ehilzenrath@bracheichler.com
Vanessa Coleman | 973.364.5208 | vcoleman@bracheichler.com

*This is intended to provide general information, not legal advice. Please contact the authors if you need specific advice.

Related Practices:   Healthcare Law

Related Industry:   Healthcare