Tag: Braces
Florida man pleads guilty of $3.6M scheme
March 5, 2024HME News Staff
TRENTON, N.J. – Steve Chicoye of Orlando, Fla., has pleaded guilty to one count of conspiracy to commit health care fraud, according to U.S. Attorney’s District of New Jersey. According to documents filed in the case and statements made in court, Chicoye and his conspirators solicited and received kickbacks and bribes in exchange for providing DME companies with completed doctors’ orders for medically unnecessary DME, such as orthotic braces. Chicoye and his conspirators utilized...
OHD partners with manufacturers for ‘better results’
December 26, 2023HME News Staff
DUNEDIN, Fla. – One Health Direct, a marketer and patient engagement solution provider for DME, has announced it is partnering with manufacturers like Mobility Braces to help them design and provide products. OHD helped Mobility Braces develop a series of PDAC-approved orthotic bracing products, including back, wrist, ankle and knee braces, that address the unique needs of elderly patients. “Most DMEs provide the same brace for a young athletic patient as they would a geriatric patient,...
Market changes likely to drive increase in audit activity
December 1, 2023Liz Beaulieu, Editor
YARMOUTH, Maine – The end of Medicare’s competitive bidding program for knee and back braces on Dec. 31 could open the door to increased audit activity for orthotics in 2024, industry consultants predict.
“We’ve already seen the Supplemental Medical Review Contractor (SMRC) add braces back onto their project list and the Recovery Audit Contractor (RAC) still has them on their approved list,” said Kelly Grahovac, general manager of the van Halem Group. “But...
Texas man pleads guilty in brace scheme
November 20, 2023HME News Staff
ATLANTA – A Texas man and owner of two DME companies has pleaded guilty to conspiracy for his role in a scheme to pay illegal kickbacks, resulting in more than $20 million submitted in claims to and $11 million in payment from Medicare. According to the charges and other information presented in court, between about June 2016 and February 2019, Simon Orobor owned and operated Devotion Medical Supply and Durable Medical Supply, Inc., which provided durable medical equipment such as knee, back,...
Two plead guilty in brace scheme
November 14, 2023HME News Staff
ATLANTA – Brett Weiner and Valerie Desalvo have pleaded guilty to federal conspiracy charges for their role in buying and selling fake doctors’ orders used to obtain more than $1.5 million in fraudulent payments from Medicare, according to the U.S. Attorney’s Office for the Northern District of Georgia. Weiner and Desalvo owned and operated Laboratory Marketing Services, a business in Boca Raton, Fla., that, among other things, received kickback payments in exchange for patient...
Nurse charged with brace scheme
October 10, 2023HME News Staff
BOSTON – A Virginia-based nurse practitioner has been charged with one count of conspiracy to commit health care fraud in connection with a $7.8 million telemedicine fraud scheme involving medically unnecessary DME, including back and knee braces. According to charging documents, between December 2018 and April 2020, Daphne Jenkins worked with a telemedicine company to sign orders for medically unnecessary DME. She allegedly signed orders that were pre-populated based on telemarketing calls...
Woman charged in $17.3M brace and CGM scheme
December 20, 2022HME News Staff
NEW YORK – Alexandra Stchaslivteseva, 52, of New York has been arrested for allegedly offering and paying illegal health care kickbacks and money laundering, resulting in Medicare paying more than $17.3 million in false claims. She allegedly offered and paid kickbacks and bribes to several purported telemedicine companies and marketing companies in exchange for completed doctor orders of medically unnecessary orthotic braces and continuous glucose monitors for Medicare beneficiaries. Stchastlivtseva...
Two sentenced for orthotics-related fraud
December 12, 2022HME News Staff
TAMPA and RALEIGH, N.C. – Ruth Bianca Fernandez has been sentenced to three years in prison for her role in a conspiracy to commit health care fraud and for making a false statement in a matter involving a federal health care benefit program. Government officials say Fernandez, who worked directly under Patsy Truglia, who has already been sentenced, and other conspirators generated medically unnecessary physician orders via their telemarketing operation for certain orthotic devices—knee...
CMS addresses urgent need for orthotics
April 18, 2022HME News Staff
WASHINGTON – CMS has published a FAQ for situations when patients need orthotic braces earlier than the two-day expedited timeframe. The agency says providers need to bill claims for L0648, L0650, L1832, L1833 and L1851 in these situations with the ST modifier and they will not undergo prior authorization. In a competitive bidding area, they need to bill these claims with the modifiers KV, J5 or J4, along with the ST modifier. Starting April 13, L0648, L0650, L1832, L1833 and L1851 were...
Jury convicts DME owners in brace scheme
July 13, 2021HME News Staff
DALLAS – A federal jury has convicted Dallas area owners and operators of two DME companies of one count of conspiracy to defraud the United states and to pay and receive health care kickbacks, and one count of conspiracy to commit money laundering. According to evidence presented at trial, Leah Hagan and Michael Hagen, the owners and operators of Metro DME Supply and Ortho Pain Solutions, paid a fixed rate per DME item in exchange for prescriptions and paperwork completed by telemedicine doctors...