Two sentenced for orthotics-related fraud 

TAMPA and RALEIGH, N.C. – Ruth Bianca Fernandez has been sentenced to three years in prison for her role in a conspiracy to commit health care fraud and for making a false statement in a matter involving a federal health care benefit program. Government officials say Fernandez, who worked directly under Patsy Truglia, who has already been sentenced, and other conspirators generated medically unnecessary physician orders via their telemarketing operation for certain orthotic devices—knee braces, back braces, wrist braces and other braces. Through the operation, the personal and medical information of Medicare beneficiaries was harvested to create unnecessary orders. The orders were then forwarded to purported “telemedicine” vendors that, in exchange for a fee, paid illegal bribes to physicians to sign the orders, often without ever contacting the beneficiaries to conduct the required telehealth consultations. The fraudulent orders were then returned to Truglia’s telemarketing operation, which used the orders as support for millions of dollars in false and fraudulent claims submitted to Medicare. To avoid scrutiny, Truglia and Fernandez spread the fraudulent claims across five DME storefronts operated under Truglia’s control and Fernandez’s day-to-day management. In all, they caused approximately $25 million in fraudulent DME claims to be submitted to Medicare, resulting in approximately $12 million in payments…Tanya Grant, who led Carolina Rehab Products, also known as Atlantic Brace, and Blue File, has been sentenced to 80 months in prison for a health care fraud scheme she carrier out between 2017 and 2021. Government officials say Grant purchased lists of Medicare patient names from companies overseas and then billed Medicare for equipment that, in many cases, she never shipped. She also billed Medicare for equipment to 422 deceased individuals. In total, Grant used two companies to bill Medicare for more than $50 million in DME between 2014 and 2021, of which Medicare paid $17 million. She used the funds to purchase a home, multiple vehicles (including a Porsche), a boat, jewelry and electronics.