Doctor convicted for $5.4M Medicare fraud scheme

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A federal jury convicted a New Jersey doctor April 26, 2024, for causing the submission of over $5.4 million in fraudulent claims to Medicare for orthotic braces ordered through a telemarketing scheme.

According to a press release from the Justice Department, quoting from court documents and evidence presented at trial, Dr. Adarsh Gupta, 51, of Sewell, NJ, signed thousands of prescriptions for orthotic braces for over 2,900 Medicare beneficiaries whom he was connected with by telemarketers who convinced the beneficiaries to accept unnecessary braces. After briefly speaking to the beneficiaries over the telephone, Gupta prescribed orthotic braces for them.

According to the press release, Gupta prescribed a back brace, shoulder brace, wrist brace, and knee brace for an undercover agent after speaking with the agent for just over a minute on the telephone. In another instance, Gupta prescribed a knee brace for a Medicare beneficiary whose legs had previously been amputated.

“The evidence presented at trial showed that Gupta could not possibly have diagnosed the beneficiaries or determined that the braces were medically necessary during his brief telephonic encounters with them,” the Justice Department said.

“Gupta’s false prescriptions were used by brace supply companies to bill Medicare more than $5.4 million,” the press release said.

The jury convicted Gupta of three counts of health care fraud and two counts of false statements relating to health care matters. He is scheduled to be sentenced on October 8, 2024 and faces a maximum penalty of 10 years in prison on each of the health care fraud counts and five years in prison on each of the false statements relating to health care matters counts. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.