A Kansas anesthesiologist was sentenced to three years in prison for a telemarketing scheme that billed Medicare for medically unnecessary orthotic braces, according to a March 6 news release from the Justice Department.
The move comes after CMS implemented a six-month nationwide moratorium on new Medicare enrollment for certain DMEPOS suppliers, including applications for initial enrollment and certain changes in majority ownership. The agency said it stopped more than $1.5 billion in suspected fraudulent DMEPOS billing last year.
What happened?
- From 2017 to 2020, Scott Roethle, MD, signed thousands of orthotic brace prescriptions for Medicare beneficiaries he never evaluated. Overseas call centers obtained Medicare information from elderly patients, and physicians involved in the scheme signed brace orders while falsely claiming to be the patients’ treating physician.
- Brace suppliers then mailed the devices and billing companies submitted the claims to Medicare. Dr. Roethle received about $30 for each fraudulent order and was paid $674,000 from five companies.
- Dr. Roethle was also ordered to pay $8.3 million in restitution.Medicare paid out at least $8 million based on the fraudulent prescriptions. Federal investigators said Dr. Roethle provided no follow-up care after signing the orders.
