Prison Sentence for Orthotic Upcoding

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A U.S. District judge sentenced James O'Connor, owner of O'Connor Medical Supply, Clive, Iowa, to 37 months in federal prison after he pled guilty in June to one count of making and using false documents, according to an article published in The Gazette. O'Connor admitted to upcoding and providing a false document intended to conceal that he submitted a claim to Medicare for a more complex and expensive orthotic device than what he provided, the news article said. The judge also ordered O'Connor to make $349,953 in restitution to Medicare and Medicaid programs, and he paid $898,523 to resolve the civil False Claims Act investigation.

Court documents showed an employee told investigators that O'Connor forged the signatures of doctors who prescribed orthotic devices by cutting and pasting the signatures from one document to another, making it seem as though the doctors had prescribed more expensive devices, according to the article.

The judge said during sentencing that O'Connor's criminal conduct was "sophisticated," and she found the crime was one of "greed, deception, and lying." She also denied O'Connor's request for a sentence of one day, noting that a substantial aggravating factor was forging signatures of doctors, the newspaper reported.