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Ohio Doctor Sentenced to Prison for $14M Healthcare Fraud Scheme

A Lorain County man has been sentenced to prison for his role in a healthcare billing conspiracy scheme that was intended to fraudulently bill Medicare for more than $14.5 million. Timothy Sutton, 44, of North Ridgeville, Ohio, was sentenced to 64 months (5 years and 4 months) in prison. He was also ordered to serve 3 years of supervised release and pay nearly $6 million in restitution to the US Department of Health and Human Services. According to court documents, Sutton used his position as a licensed medical doctor in the state of Ohio to cause submission of claims on behalf of patients who did not need the medical treatment. He was employed by two telemedicine companies based in Florida which provided him 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 each patient using a telemedicine platform and then determined that they needed DME. He also falsely affirmed that he was the treating physician of the patients who he had signed orders to receive CGX testing. However, federal investigators found that Sutton never examined any of the patients whom he claimed to have examined.