Ohio doctor ordered to repay $1 million to Medicare after writing phony orders for unnecessary medical equipment and lab tests

An Ohio physician who pleaded guilty to defrauding Medicare must repay nearly $1 million back to the agency but was spared from serving prison time.

Muna Orra, 42, of Westlake, Ohio, received five years of probation by U.S. District Judge John R. Adams for her role in the healthcare fraud conspiracy.

Orra electronically signed orders for equipment and tests without examining patients in a scheme designed to fraudulently bill Medicare for more than $1.8 million, the U.S. Attorney’s Office for the Northern District of Ohio shared in a news release.

Orra pleaded guilty in January to making false statements related to health care matters. Adams ordered she pay $997,641 in restitution to the Centers for Medicare and Medicaid Services.

Medicare provides health benefits mainly to individuals age 65 and older or to those who meet certain criteria. Across the country, federal authorities are uncovering widespread fraud in government-funded Medicare and Medicaid programs.

Besides prosecuting fraudsters, CMS Administrator Mehmet Oz said the federal government is focused on clawing back stolen funds from state programs and convicted criminals. Oz is traveling the country to investigate how different fraud schemes work, including a recent visit to Ohio.

Orra’s sentencing follows federal and state indictments involved $42 million in Medicaid fraud in Ohio. The state’s Supplemental Nutrition Assistance Program also has been defrauded out of millions through organized card skimming and fraudulent retailers and recipients stealing benefits.

Orra, a licensed medical doctor in Ohio, signed orders for durable medical equipment, primarily braces, and genetic testing for patients who did not need the equipment and tests, according to court documents.

The fraudulent claims were made between February 2018 and September 2021, when Orra worked as an independent contractor physician for a Georgia-based telemedicine.

She electronically approved the orders for the DME and genetic tests based on documents provided by the telemedicine company, which then submitted bills for the equipment and tests.

Orra’s orders were used as “purported proof those items were medically necessary,” the U.S. Attorney’s Office said.

The FBI Cleveland Division and the Department of Health and Human Services – Office of Inspector General investigated the case, leading to Orra’s prosecution.

During an investigation, authorities determined Orra did not “meaningfully review the patient records to determine if the prepared orders were medically reasonable and necessary.”

In addition, she did not conduct required in-person assessments despite signing orders indicating that she did.

Orra also had a pattern of electronically signing the orders “within just seconds of accessing the patient file,” indicating she did not meaningfully review the patients’ files.

Prosecutors said Medicare was fraudulently billed $93,473 for medically unnecessary genetic testing orders and $1,749,051 for medically unnecessary braces for patients.

Medicare paid approximately $64,189 on those bills for genetic testing and $933,452 on the bills for braces.

The U.S. Attorney’s Office for the Northern District of Ohio covers the 40 northern-most counties in Ohio, which is home to nearly 6 million people. Orra’s case isn’t the only recent healthcare fraud scheme prosecuted by that office.

In January, Timothy Sutton, 44, of North Ridgeville, Ohio, was sentenced to 64 months in prison for his role in a similar healthcare billing conspiracy scheme that billed Medicare more than $14M for unnecessary medical equipment and lab tests, the office shared in a news release.

Similar to Orra, Sutton, also a licensed medical doctor, was employed by two telemedicine companies based in Florida. The companies provided him with pre-completed orders for durable medical equipment, and he digitally signed off on prescriptions for the equipment without examining any patients.

In April, the U.S. Department of Justice announced the creation of the National Fraud Enforcement Division to investigate and prosecute “those who steal or fraudulently misuse taxpayer dollars,” the DOJ said. The Fraud Division supports the work of the newly created Task Force to Eliminate Fraud, chaired by Ohio native Vice President J.D. Vance.