Todd Roberts, 47, of Old Saybrook, was sentenced Feb. 25 by U.S. District Judge Stefan R. Underhill in Bridgeport to three years of probation for obstructing a federal audit.
In addition, Roberts, owner of Roberts Physical and Aquatics Therapy, entered into a civil settlement agreement with the government in which he will pay $328,828 to resolve allegations that he violated the False Claims Act for conduct occurring between April 5, 2007 and March 31, 2010.
He also entered into 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. In entering into the civil settlement agreement, Roberts did not admit liability.
Judge Underhill required that as a condition of his probation, he comply with the terms of the Integrity Agreement and pay the entire amount of money owed.
According to court documents and statements made in court, on January 23, 2009, a Medicare contractor informed Roberts and the company, located at 210 Main Street in Old Saybrook, that the contractor was performing an audit of the practice.
Roberts instructed an employee to delay the audit by telling the contractor that medical records were stored at a nonexistent storage facility. He then rented a storage unit at a local facility and used the delay to alter and augment patient records. Specifically, Roberts, and an employee at his direction, 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 beneficiaries had obtained direct, one-on-one service from a licensed physical therapist when, in fact, some of the services had been rendered by unlicensed auxiliary personnel.
On September 25, 2012, Roberts waived his right to indictment and pleaded guilty to one count of obstructing a federal audit. The civil allegations against Roberts and his business involve improper billing to Medicare for physical and aquatic therapy services between April 2007 and March 2010.
The government alleges that Roberts regularly billed Medicare for direct, one-on-one therapeutic procedures when such services were not provided. At the clinic, physical therapists and physical therapy assistants would routinely provide therapy services to multiple patients at the same time. Nevertheless, the services provided to each patient were billed as if the physical therapist or physical therapy assistant had provided direct, one-on-one care. For example, patients were routinely left alone to perform exercises in the aquatic therapy pool, with no direct, one-on-one contact with licensed personnel.
The government alleges that Roberts routinely failed to document their therapy services. This was particularly egregious during the first six months of its operation, when the clinic did not have any documentation at all showing that the services in question were actually provided.
This matter was investigated by the Office of Inspector General for the Department of Health and Human Services, the Federal Bureau of Investigation, and the Office of the Inspector General for the Department of Veterans Affairs. The case was prosecuted by Assistant United States Attorneys David J. Sheldon and Richard M. Molot, and Auditor Susan Spiegel.
People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.
Information supplied by the U.S. Attorney's office for Connecticut