GUILFORD PODIATRIST PLEADS GUILTY TO MEDICARE FRAUD
Deirdre M. Daly, Acting United States Attorney for the District of Connecticut, announced that RICHARD SOKOLOFF, 70, of Guilford, waived his right to indictment and pleaded guilty today before United States District Judge Janet Bond Arterton in New Haven to one count of health care fraud.
According to court documents and statements made in court, SOKOLOFF was a podiatrist with a practice at 652 Boston Post Road in Guilford. Between July 2008 and February 2012, SOKOLOFF engaged in a health care fraud scheme by submitting claims to Medicare for avulsion of nail plate services which were not rendered. An avulsion of nail plate service, or “nail avulsion,” is a surgical procedure to treat ingrown toenails. The procedure involves the surgical separation and removal of all or part of a toenail from the tip of the nail back to the base of the nail. Pursuant to relevant Medicare policies, the procedure is required to be performed using injectable anesthesia unless the patient is devoid of sensation or there are other extenuating circumstances. Injectable anesthesia is necessary to perform a partial or full nail avulsion to avoid causing extreme pain to the patient.
The investigation revealed that SOKOLOFF commonly provided only “routine foot care” services to his Medicare patients, such as simply trimming or clipping their toenails, but he regularly submitted claims to Medicare as if he had performed nail avulsion surgical procedures. Routine foot care is typically not a payable service under relevant Medicare regulations except in limited circumstances for patients with certain systemic conditions or other significant medical issues. SOKOLOFF also did not use an injectable anesthetic while supposedly providing nail avulsion services.
When Medicare requested that SOKOLOFF provide documentation to substantiate his nail avulsion services, SOKOLOFF created and back-dated patient progress notes to make it appear that the avulsion of nail plate services had been performed when, in fact, they had not been performed.
SOKOLOFF was paid more than $200,000 by Medicare for nail avulsion services that had not been performed.
Judge Arterton has scheduled sentencing for October 3, 2013, at which time SOKOLOFF faces a maximum term of imprisonment of 10 years and a fine of up to $250,000.
As part of the resolution of this matter, SOKOLOFF has agreed to a 10-year exclusion from all federal health care programs.
This investigation was conducted by special agents from the Office of Inspector General for the Department of Health and Human Services and the Federal Bureau of Investigation. The case is being prosecuted by Assistant United States Attorney Richard M. Molot and Auditor Kevin Saunders.
Acting U.S. Attorney Daly encourages individuals who suspect health care fraud to report it by calling the Health Care Fraud Task Force at (203) 777-6311 or. 1-800-HHS-TIPS.
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