A doctor was sentenced last Thursday to four years in prison for a $6.3 million Medicare fraud scheme in which elderly and disabled patients were sent thousands of orthotic braces that they did not need.
According to court documents and evidence presented at trial, Sophie Toya, M.D., 56, of Bloomfield Hills, prescribed more than 7,900 orthotic braces to more than 2,600 Medicare patients during a six-month period.
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, and she had no contact at all with the others. Toya nonetheless signed orders prescribing more than 7,900 braces, including prescribing four or more braces to nearly 1,000 patients.
Toya prescribed as many as 136 braces in a day, 12 braces for a single patient, and numerous braces for undercover agents posing as Medicare beneficiaries after speaking with them by telephone for less than a minute.
The prescriptions and accompanying medical records signed by Toya falsely represented that the braces were medically necessary and that she diagnosed the beneficiaries, had a plan of care for them, and recommended that they receive certain additional treatment.
On May 10, 2024, Toya was convicted following an eight-day trial on one count of health care fraud and five counts of false statements relating to health care matters.
Toya was also ordered to pay $3,606,935 in restitution and $120,475 in forfeiture.
According to court documents and evidence presented at trial, Sophie Toya, M.D., 56, of Bloomfield Hills, prescribed more than 7,900 orthotic braces to more than 2,600 Medicare patients during a six-month period.
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, and she had no contact at all with the others. Toya nonetheless signed orders prescribing more than 7,900 braces, including prescribing four or more braces to nearly 1,000 patients.
Toya prescribed as many as 136 braces in a day, 12 braces for a single patient, and numerous braces for undercover agents posing as Medicare beneficiaries after speaking with them by telephone for less than a minute.
The prescriptions and accompanying medical records signed by Toya falsely represented that the braces were medically necessary and that she diagnosed the beneficiaries, had a plan of care for them, and recommended that they receive certain additional treatment.
On May 10, 2024, Toya was convicted following an eight-day trial on one count of health care fraud and five counts of false statements relating to health care matters.
Toya was also ordered to pay $3,606,935 in restitution and $120,475 in forfeiture.
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