Federal jury convicts Michigan doctor for Medicare fraud over telemarketed orthotic braces

A federal jury has convicted a Michigan doctor, Sophie Toya, M.D. today for causing the submission of over $6.3 million in fraudulent claims to Medicare for medically unnecessary orthotic braces ordered through a telemarketing scheme. according to reports and Court documents, Dr. Toya signed thousands of prescriptions for orthotic braces for over 2,500 Medicare patients during a six-month period. She was not the treating physician for any of them . Instead, she was connected with some of the patients by telephone through a telemarketing scheme and spoke to the patients briefly before signing orthotic brace prescriptions for them. For other patients,

Dr. Toya signed prescriptions without having any contact with them. In one case,, she prescribed 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. Toya also prescribed multiple braces for undercover agents posing as five different Medicare patients after speaking to each agent for less than a minute over the telephone.

The Government asserts that she could not possibly have diagnosed the patients or determined that the braces were medically necessary for them.

The jury convicted Toya of one count of health care fraud and five counts of false statements relating to health care matters.

Jeffrey Newman is a whistleblower lawyer and former reporter, whose firm represents whistleblowers in healthcare fraud cases under the False Claims Act (FCA) and also under the Securities and Exchange, FINCEN and CFTC whistleblower programs. He can be reached at Jeff@JeffNewmanLaw.com or at 617-823-3217