A Michigan physician was sentenced to four years in prison for her role in a $6.3 million Medicare fraud scheme.
What happened?
- Sophie Toya, MD, 56, of Bloomfield Hills, prescribed more than 7,900 orthotic braces to more than 2,600 Medicare patients during a six-month period, according to a June 26 Justice Department news release.
- The patients were solicited through deceptive TV 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. Dr. Toya spoke to some of the patients on the phone, but had no contact with others.
- Her false prescriptions were used by brace supply companies to bill Medicare more than $6.3 million, and she was paid about $120,000 by telemedicine companies in exchange for signing the fraudulent prescriptions.
- She was convicted in May 2024 of one count of health care fraud and five counts of false statements relating to health care matters.
- Dr. Toya was also ordered to pay more than $3.6 million in restitution and more than $120,000 in forfeiture.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
