Orthotic braces are used to provide support to a weakened body part or joint. They are commonly worn after suffering an injury or undergoing surgery. Some braces, however, are used to address long term or chronic conditions. Osteoarthritis, scoliosis and severe back pain are among them.
“One of the key reasons a person needs a brace or an orthotic is to help ensure force is distribution safely and evenly across the foot,” informs the Orthopaedic Foot & Ankle Center, “A custom orthotic can do a better job at distributing force because it can be designed based on pressure imaging that allows the doctor to see how force is being managed in your foot without a brace. They’ll then design an orthotic to shift forces and take pressure off injured areas.”
Doctor convicted for scam involving orthotic braces.
Last week Friday, the Office of Public Affairs announced that a New Jersey-based doctor was convicted in a $5.4 million Medicare scam. 51 year-old, Adarsh Gupta was found guilty following a case that accused him of submitting fraudulent claims to Medicare for orthotic braces. Both court documents and evidence presented at trial made evident that the physician utilized telemarketers to convince Medicare beneficiaries to accept the braces unnecessarily.
Gupta, in fact, signed thousands of orthotic braces prescriptions for over 2,900 Medicare beneficiaries. He would speak to these individuals only for brief periods over the phone before writing the prescriptions. In one instance, Gupta prescribed a knee brace for a Medicare beneficiary whose legs had already been amputated.
Gupta spoke to an undercover agent over the phone.
The investigation of Gupta’s actions came to a head when he unknowingly spoke to an investigating agent on the phone. After a conversation lasting just over a minute, the doctor prescribed a back brace, shoulder brace, wrist brace and knee brace. As the Office of Public Affairs report makes clear, the evidence presented at the trial showed that Gupta could not possibly have diagnosed the beneficiaries or determined that the braces were medically necessary during his brief telephonic encounters with them.
“Nonetheless, Gupta signed prescriptions for braces that falsely represented that the braces were medically necessary and that he diagnosed the beneficiaries, had a care plan for them, and recommended that they receive certain additional treatment,” reads the report, “Gupta’s false prescriptions were used by brace supply companies to bill Medicare more than $5.4 million.”
Gupta is scheduled for sentencing on October 8, 2024.
The physician was convicted of three counts of health care fraud and two counts of false statements relating to health care matters. He faces a maximum penalty of 10 years in prison on each of the health care fraud counts. He also faces a maximum penalty of five years in prison on each of the false statements relating to health care matters counts.
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