MICHIGAN – A Michigan jury on Friday convicted a doctor for “causing the submission” of more than $6 million in fraudulent Medicare claims, according to the U.S. Department of Justice.
The false Medicare claims were for unneeded “orthotic braces,” which were ordered through a telemarketing scheme, officials said in a press release.
Trial evidence showed that 55-year-old Dr. Sophie Toya, M.D., 55, of Bloomfield Hills, “signed thousands of prescriptions for orthotic braces for more than 2,500 Medicare patients” over six months.
Toya was not the doctor treating the patients but rather spoke to them through a telemarketing scheme, which resulted in her writing prescriptions for the unnecessary orthotic braces,”the DOJ press release says.
The prescriptions included a lower back brace, right and left shoulder braces, a right wrist brace, right and left knee braces, and right and left ankle braces for “a single Medicare patient,” it adds.
And Toya unknowingly spoke to undercover agents posing as Medicare patients for less than a minute each on the phone before prescribing them multiple braces. Toya, evidence at trial showed, would have been unable to properly diagnose the patients in such a short amount of time, the release notes.
Medicare was billed over $6.3 million based on the false prescriptions approved by Toya, who was paid about $120,000 in exchange for her authorizations, federal officials say.
The jury convicted Toya of healthcare fraud and five counts of making medical statements.
She faces up to 35 years in prison when she is sentenced Aug. 15.
The FBI and the Department of Health and Human Services Office of Inspector General investigated the case as part of Operation Rubber Stamp, which is a nationwide law enforcement effort targeting medical professionals involved in “fraudulent telemedicine schemes.”
