Feds say NC doc scammed millions for unneeded braces, including knee brace for amputee
.jpeg "A Charlotte doctor has been indicted on charges of submitting $11.5 million in fraudulent reimbursement claims for unnecessary orthopedic braces.")
Over a two-year period, a Charlotte doctor fraudulently filed for medical reimbursements for almost $11.5 million in unnecessary orthopedic braces — including a knee brace for an amputee, a new federal court filing claims.
Now Sudipta Mazumder is bracing for her day in court.
On Thursday, the 46-year-old internist with Carolina Medical Associates was indicted and charged with one count of medical fraud and six counts of making false statements relating to health care matters.
The fraud charge carries a maximum penalty of 10 years in prison and a $250,000 fine. Each count of making a false statement includes up to a five-year sentence and a $250,000 fine.
Mazumder is scheduled to appear in court on July 12, court records show. She did not immediately respond Friday morning to a phone message left at her office by The Charlotte Observer, nor did her case file list the name of a defense attorney.
She becomes the latest medical figure implicated in reimbursement fraud involving so-called “durable medical equipment,” better known as DME.
In December, for one example, the owners of two DME companies in Texas were each sentenced to more than 12 years in prison for paying tens of millions of dollars in kickbacks to co-conspirators who filed $59 million in fraudulent Medicare claims. The defendants were also ordered to pay $27 million in restitution.
According to the U.S. Attorney’s Office in Charlotte, as well as the allegations in her indictment, Mazumder signed off on thousands of fraudulent DME reimbursement claims to Medicare and TRICARE, a medical program for active and retired military personnel and their families. In one case, she prescribed five braces for various body parts for the same North Carolina patient, her indictment claims.
She did so on the side of her full-time medical practice while serving as an independent contractor for an unidentified telemedicine firm based in Delaware, the indictment claims.
Mazumder signed most of the DME orders for the patients she was supposedly treating “without seeing, speaking to and otherwise communicating with and examining them,” according to the indictment.
“These orders, as Mazumder knew, were not medically necessary and were not the product of a doctor-patient relationship and examination.”
That didn’t mean she did not get paid. According to the indictment, the Delaware firm paid Mazumder a $20 kickback for every telemedicine “consultation.”
There were many. Between late January 2019 to late May 2020, Mazumder submitted or helped submit just under $11 million in false claims to Medicare and almost $510,000 to TRICARE, her indictment alleges.
For one telemedicine patient — a Medicare and TRICARE beneficiary from Fayetteville identified in the indictment as W.S. — Mazumder prescribed the equivalent of a DME suit of armor.
According to the indictment, she filed the paperwork for a brace for W.S.’s back, his ankle, a knee, a shoulder and one of his wrists.
