An Ohio doctor has pleaded guilty to his role in a conspiracy that prescribed medical equipment and lab tests for patients who did not need them and then submitted claims to Medicare to receive payment. According to court documents, Timothy Sutton, 43, of North Ridgeville, Ohio, admitted that he and other co-conspirators engaged in a scheme to fraudulently bill more than $14.5 million in payments from Medicare. Sutton was employed by two telemedicine companies; Real Time Physicians, LLC, based in Nevada, and 24-Hour Virtual MD, LLC, based in Florida. The companies provided Sutton with pre-completed orders for durable medical equipment (DME), such as braces, and/or cancer genetic testing (CGX) for him to approve and digitally sign. In doing so, he affirmed that he had examined patients using a telemedicine platform and determined that they needed DME or that CGX testing was necessary. In truth, he never examined any of the patients who resided throughout Ohio and Florida.
Once Sutton prescribed the equipment or ordered testing, Real Time Physicians and 24-Hour Virtual MD furthered the conspiracy by forwarding the orders to companies under their control or sold the orders to other medical entities to provide DME or conduct the lab testing. Sutton defrauded Medicare by submitting claims that were not reasonable and necessary for medical treatment and did not comply with Medicare rules and regulations or applicable federal laws.
