Fraud: Physician Sentenced and Fined for Altering Medical Records to Induce Medicare Payments

October 31, 2014 | Strategic Insights for Ambulatory Care


​A Virginia podiatrist pleaded guilty to four counts of lying to a grand jury about falsifying patient medical records to make it appear that she prescribed a medical device to help with bone growth at a time later than when she actually prescribed the device. She was sentenced to five months in prison, five months of home confinement, and two years of supervised release. A bone growth device stimulator is an external device that can help regenerate bone cells and help bones heal after a fracture; Medicare only pays for these devices only if fracture healing has been delayed for at least three months. According to reports, the podiatrist would prescribe the device earlier than required for Medicare reimbursement, and then the podiatrist, the medical device territory manager, and the podiatrist's employee would falsify medical records to indicate that at least 90 days without fracture healing had occurred before the device was prescribed.

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