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Old Saybrook physical therapist will pay $328,000 to settle Medicare fraud case

By Joe Wojtas

Publication: TheDay.com

Published February 25. 2013 6:00PM   Updated February 26. 2013 12:21AM

Old Saybrook — Local physical therapist Todd Roberts was sentenced to three years of probation Monday for obstructing a federal audit while he and his firm, Roberts Physical and Aquatics Therapy, agreed to pay a $328,828 settlement to the federal government for filing false Medicare claims, according to the U.S. Attorney's office.

According to a press release from the U.S. Attorney, court documents and statements, a Medicare contractor informed the Main Street practice that it would be conducting an audit of its operations in January 2009,

Roberts, 47, instructed an employee to delay the audit by saying medical records were stored at a nonexistent storage facility. He then rented a storage unit and "used the delay to alter and augment patient records."

The U.S. Attorney said he and another employee "created and added patient progress notes when no notes had been created at the time of service."

The notes made it appear as though Medicare patients had been treated by a licensed physical therapist even though unlicensed auxiliary personnel had provided some of the treatment. On Sept. 25, 2012, Roberts pleaded guilty to one count of obstructing a federal audit.

The U.S. attorney said the civil allegations and settlement involved improperly billing Medicare for physical and aquatic therapy services between 2007 and 2010.

While Medicare pays for outpatient therapy services provided by physicians, physical therapists, and licensed physical therapy assistants, it does not pay for services provided by support personnel such as physical therapy aides, athletic trainers or student trainees.

The U.S. attorney alleged Roberts and his practice regularly billed Medicare for direct, one-on-one therapeutic procedures when none were given. It also alleged he routinely failed to document therapy services including its first six months of operation, when the clinic had no documentation to show it actually provided services.

Roberts and the practice will pay $328,828 to resolve its liability under the False Claims Act. In entering into the civil settlement agreement, he and the practice did not admit liability. They also entered a six-year Integrity Agreement with the U.S. Department of Health and Human Services "that is designed to ensure future compliance with the requirements of the Medicare program, including the proper rendering of therapy services and the submission of only valid claims to Medicare for payment."

— Joe Wojtas

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