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An Infomercial for Fraud

An Infomercial for Fraud

Healthcare-10
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Hard to deny that infomercials know how to sell using a variety of techniques that create a sense of urgency and appeal to emotions that capture viewer attention. They encourage them to buy what was earlier not necessarily wanted. A perfect tactic for a fraudster scheming to sell thousands of orthotic braces on the taxpayers dime. Like Dr. Sophie Toya who prescribed over 7,900 orthotic braces to more than 2,600 Medicare patients watching TV.

The patients were solicited through deceptive television commercials offering free back braces. When they called the advertised telephone number, they were persuaded to accept braces for other parts of their bodies, with the promise that Medicare would pay. Toya spoke to some of these patients briefly over the phone, although for the most part she had no contact with most of them. Nonetheless, Toya prescribed orthotic braces and many times as many as 136 braces in a day. In the case of one patient, to whom Toya prescribed five braces for which Medicare was billed $3,883, she falsely attested that she evaluated the patient and that the patient was mobile when, in fact, the patient had long been confined to a wheelchair, could not walk or stand, and was suffering from a dangerous spinal infection that could not be treated by braces but instead required spinal surgery.

The prescriptions and accompanying medical records signed by Toya falsely represented that the braces were medically necessary, including the prescriptions she signed for the undercover agents posing as Medicare beneficiaries. Toya’s many false prescriptions were used by brace supply companies to bill Medicare more than $6.3 million.

On June 26, 2025, Dr. Sophie Toya was sentenced to four years in prison for Medicare fraud.

Great job by the HHS Office of Inspector General (OIG) in this case.

Today’s Fraud of The Day is based on article “Michigan Medicare Fraud For Orthotic Braces Case Ends With Harsh Prison Term for Bloomfield Hills Doctor” published by Thumb Wind News on June 28, 2025.

A Bloomfield Hills, Michigan, physician, Dr. Sophie Toya, 56, received a four-year federal prison sentence on June 26, 2025, for orchestrating a $6.3 million Medicare fraud involving thousands of medically unnecessary orthotic braces. The Justice Department announced that Toya prescribed more than 7,900 braces to over 2,600 elderly and disabled patients in just six months, frequently without any clinical contact or medical necessity.

Patients were solicited via deceptive television ads offering free back braces. Once they called, operators persuaded them to accept additional braces—arm, leg, or ankle—with claims that Medicare would cover the cost. Toya spoke with some patients briefly; many received prescriptions signed by her without any evaluation.

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