If the Shoe Fits, Wear It

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If a shoe doesn’t fit, you wouldn’t want to wear it. (No one likes to wear shoes that hurt their feet.) Similarly, for people who wear prosthetics, a custom fit is a necessity. An article published by the St. Louis Post-Dispatch follows the story of a man accused of illegally collecting benefits from Medicare and Medicaid by selling used instead of new prosthetic legs to his customers.

According to the story, the man who owned the prosthetic company allegedly told multiple insurance companies that the fake limbs he sold were new and custom-fitted. The story also states that for seven years, the man and his company purportedly bought used prosthetic legs online or received them from families of patients who no longer needed them.

When customers complained that the limbs did not fit, the man reportedly tried to repeatedly fix the prosthetic limbs to no avail. (Since the limbs were used to begin with, they never quite fit right because they were not custom-fitted.) Court documents show that there was one instance where the man’s company purportedly bought a leg and returned it, then used the statement to convince a patient that an old leg was really new.

The 53-year-old prosthetic leg company owner is currently charged with four counts of health care fraud and one count of lying to a federal agent. (He allegedly told an FBI agent that he had never provided used prosthetic legs to any of his patients.) The charges are related to $155,000 in Medicare and Medicaid claims for four new prosthetic legs. (That’s about $36,000 a leg.)

The article reports that the man has been indicted by a federal grand jury and has an upcoming court date scheduled. He is, of course, innocent until proven guilty. (It will be up to the grand jury and the judge to decide if the shoe fits and whether or not he will have to wear it.)

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Missouri Man Accused of Selling Used Prosthetic Legs, Claiming They Were New,” written by Robert Patrick and published by the St. Louis Post-Dispatch on August 18, 2015.

ST. LOUIS – Federal prosecutors say a Missouri man and his company sold used prosthetic legs to customers, but told patients and insurance companies that they were new.

Theodore E. Deininger, 53, and First Choice Orthotics & Prosthetics were indicted Aug. 5 on four counts of health care fraud and Deininger also faces one count of lying to a federal agent.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.