Ohio doctor faces more than five years in $5.9 million Medicare fraud
Amid lingering concerns over the possible widespread fraud, including among the Somali immigrant community in Ohio and Minnesota, an American doctor was abusing the Medicare system.
Timothy Sutton, a doctor from North Ridgeville who worked for a telemedicine company, was sentenced on Monday to more than five years in prison for ordering thousands of cancer-related tests and medical braces that were worth $14.6 million, but were not needed by his patients, according to Cleveland.com. In April, Sutton pleaded guilty to charges including aggravated identity theft, false statements related to health care matters, and attempt and conspiracy to commit wire fraud and bank fraud.
According to prosecutors, from January 2018 through October 2020, Sutton was allegedly the top prescriber of the braces in the state. U.S. District Judge David Ruiz also ordered him to pay Medicare $5.9 million in restitution for the amount he overbilled.
“You caused harm to an essential government function that would otherwise have been used on patients who needed treatment,” Ruiz said.
Sutton tried to defend himself by saying he always tried to help people and that the only reason he committed fraud was that he was ignorant of telemedicine law because he hadn’t done his research before joining two companies — Real Time Physicians LLC, and 24 Hour Virtual MD — as a part-time worker.
“I became a puppet for evil people,” he said, according to Cleveland.com. “I’m ashamed beyond belief. I allowed patients to become victims of the company, and worse, I became a vehicle for their victimization.”
The news source reported that Sutton’s medical license expired in January, and a hearing is scheduled before the Ohio Medical Board.
Assistant U.S. Attorney Michael Collyer said that Sutton worked for the companies from Jan. 26, 2018, to Oct. 21, 2020. While working there, he submitted 5,519 claims to Medicare on behalf of 3,417 patients, saying they needed knee and back braces, even though he never examined or spoke to any of them.
According to Collyer, Sutton issued as many as 25 prescriptions in 15 minutes, adding that the disgraced doctor was paid approximately $142,000 by the two companies. When Sutton learned that he was being investigated for committing fraud, he asked two companies for an additional $30,000.
“He was willing to sell his medical license for $31 per claim,” Collyer said, adding that Sutton defrauded Medicare of $5.9 million.
Before he began working for the two companies part-time, Sutton was fired from the University of Michigan’s Health System in 2013 after he overdosed on drugs he stole from the hospital inside a hospital bathroom. This scandal resulted in the U.S. Drug Enforcement Administration investigating the case and the university paying a $4.3 million settlement and agreeing to more strict guidelines in handling and tracking drugs.
After losing his job at the university, Sutton worked in occupational medicine at Firelands Regional Medical Center in Sandusky, but was fired in October 2020, allegedly for accessing medical supply cabinets to take drugs and then disposing of medicines and syringes in a public dumpster.
