Dive Brief:
- U.S. District Court Judge Nathaniel M. Gorton sentenced Virginia podiatrist Ilene Terrell to five months in prison, five months of home confinement and two years of supervised release. Terrell made false claims to the grand jury about the falsification of patient medical records in a scheme to receive payments from Medicare for Orthofix bone-growth stimulator medical devices that did not meet payment standards.
- Medicare remits payment for the bone growth stimulators (priced at $4,000) only when a bone isn't healing normally after three or more months. Terrell proscribed the stimulants before the three-month cutoff, then altered patient records with the knowledge of a former Orthofix representative.
- According to Modern Healthcare, Terrell is the eighth person sentenced in conjunction with the ongoing case, including Orthofix's former vice president of sales. She is one of only two clinicians convicted; the other was Michael Cobb, a Rhode Island PA who accepted kickbacks from Orthofix.
Dive Insight:
According to Modern Healthcare, Orthofix pleaded guilty in 2012 to obstructing a federal investigation into the incident, cutting a plea deal to the tune of $42 million and providing prosecutors with key information about company employees involved in the scheme. More notably, however, the charging of a physician comes at a time when doctors who bill Medicare are under greater scrutiny than ever. The recent Medicare data release has exposed physicians to the kind of inspection that could turn up more suits like this. This is precisely the kind scheme for which whistleblowers are combing that data.