A federal jury last week convicted a New Jersey doctor of swindling $5.4 million from Medicare through a fraudulent orthotic equipment scheme.

Court documents say Adarsh Gupta, M.D., of Sewell, signed thousands of prescriptions for orthotic braces for more than 2,900 Medicare beneficiaries who did not need the devices. Gupta identified the beneficiaries through telemarketers, according to trial evidence, then briefly speak to the beneficiaries by phone before prescribing orthotic braces for them. For example, Gupta prescribed a back brace, shoulder brace, wrist brace, and knee brace for an undercover agent after speaking with the agent for slightly more than a minute on the phone. In another instance, Gupta prescribed a knee brace for a Medicare beneficiary whose legs had previously been amputated. Government prosecutors argued and trial evidence concluded that Gupta could not possibly have adequately diagnosed the beneficiaries or determined the braces were medically necessary during a brief phone call. Nevertheless, Gupta signed prescriptions for braces that were not medically necessary, and claimed to have diagnosed the beneficiaries, created a care plan for them, and recommended they receive certain additional treatment. Gupta’s false prescriptions were used by brace supply companies to bill Medicare more than $5.4 million, the U.S. government charged.
 
The jury convicted Gupta, 51, of three counts of health care fraud and two counts of false statements. He faces a maximum 10-year prison term for each of the healthcare fraud counts and a five-year sentence on each of the false statements when he is sentenced Oct. 8. 
 
Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the U.S. Justice Department’s Criminal Division; Assistant Director Michael D. Nordwall of the FBI’s Criminal Investigative Division; and Deputy Inspector General for Investigations Christian J. Schrank of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.
 
The FBI and HHS-OIG investigated the case.
 
Trial Attorneys Darren C. Halverson and Sarah E. Edwards of the Criminal Division’s Fraud Section are prosecuting the case, with assistance from Assistant U.S. Attorney Kelly M. Lyons for the District of New Jersey. Trial Attorney Steven Michaels of the Special Matters Unit of the Criminal Division’s Fraud Section assisted with filter matters.
 
The Fraud Section leads the Criminal Division’s efforts to combat healthcare fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal healthcare programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes.