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Waiting By The Phone

Medicare enrollment form and glasses
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

With senior citizens being the largest consumers of healthcare products, Medicare is a target for fraud. And because Durable Medical Equipment (DME) is considered essential for sick and disabled Medicare beneficiaries to maintain their quality of life and live more independently, fraudsters like to focus on it. That doesn’t mean the U.S. Department of Health and Human Services isn’t fighting. Since 2022, the Department of Justice has led a nationwide coordinated law enforcement action to combat telemedicine, clinical laboratory, and durable medical equipment fraud, leading to hundreds of medical companies and professionals being called out for over a billion dollars in fraudulent Medicare claims. And the latest DME schemer has had her day in court. Dr. Ankita Singh was sentenced on July 19, 2024, for a DME scheme that caused Medicare to have paid over $4 million in fraudulent claims. Just by signing her name 11,000 times.

The scheme began with telemarketers who contacted Medicare beneficiaries to convince the beneficiaries to agree to receive braces, in the mail. The telemarketers told beneficiaries that the braces would be provided at no cost and that a doctor would contact them to confirm the order. The telemarketers would then prepare orders with the beneficiaries’ names, Medicare numbers, and purported diagnosis to support a false diagnosis that the braces were medically necessary. And forward to the doctor. Who was not near a phone.

Singh worked as an independent contractor to purportedly provide “telehealth services,” and was paid a fee to conduct patient consultations. The consultations never took place. But she signed the order, claiming to Medicare that the brace was medically necessary. Singh signed more than 11,000 prescriptions for orthotic braces for approximately 3,000 Medicare beneficiaries with whom she had no patient-physician relationship. Meaning, she never called them.

Great job by the U.S. Department of Health and Human Services – Office of Inspector General in this case.

Today’s Fraud of The Day is based on article “Maumee doctor sentenced in medical brace fraud scheme” published by WTOL News on July 19, 2024.

A doctor who had practiced in Maumee was sentenced Friday for a medical equipment fraud scheme that put Medicare out more than $4 million.

In a press release, the Department of Justice said a federal judge sentenced 42-year-old Ankita Singh to 26 months in prison following a Feb. 29 conviction on six counts of health care fraud. Prosecutors said Singh filled thousands of prescriptions for orthotic braces beginning in 2019 for Medicare beneficiaries — all of whom were not previously her patients, nor had she ever spoken to them.

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