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Avatar universal

Did doctor oirfer wrong orthotic?

Is it legal for a doctor to order the wrong orthotic and bill it to Medicaid?

I have severe pronation (both feet turn inward), fallen arches and a dropped navicular bone (a bone in my arch has collapsed, and rests on the ground).  I also have a vertical talus (a bone in my ankle is in the wrong position).

It took me years to find out these things.  My previous podiatrist told me I had a ruptured tibial tendon, from a fall I had, but the referral to the orthopedists did not follow through.   Then the podiatrist retired, and my new podiatrist ignores my tendon rupture and refused to look at my x-rays.  

My new podiatrist ordered a leg brace for my right foot, and ignored my left foot.  He said the brace would be molded from a cast of my foot, and would not correct the pronation.  It would just hold the foot in its current position.

When the brace was made, it did not have a dough nut hole to accommodate my fallen navicular bone.

I have obtained a second opinion and was told that will I need orthotics for both feet, for life, and that they should help my pronation with "posting."

My first podiatrist ignores this.  Is he committing a crime for billing Medicaid for an orthotic that I can not use, and that could cause further injury?

My feet x-rays are attached.
4 Responses
144586 tn?1284669764
Yes. Contact the qui tam officer at your local F.B.I. office before going further. Have all medical records. In every F.B.I. office a special agent is specifically assigned to Medicaid fraud. If their investigation corroborates your allegation, and involved thousands of patients seen by this physician, you may be eligible for thousands of dollars in fines collected from the physician for fraud involving all his patients.
Avatar universal
The doctor refuses to tell me how to get my  medical records.  I asked what he wrote as a diagnosis of my foot deformity, and he sent me a letter telling me to find another doctor if I am not satisfied with his service...

I found on the internet that my foot deformity needs a special orthotic...but now I found out that the orthotic my podiatrist ordered id for people with "diabetes."  So Medicaid is being billed for the WRONG type of orthotic!  I can't believe this!

I am so sorry it took me so long to answer...but I am sick and can not get to the library too often...I do not have a home computer...
144586 tn?1284669764
The doctor is required by law to provide you with as copy of your medical records. Once again, you appear to have a medicaid fraud issue, and the person  to contact is the Qui Tam agent. This is their sole assignmernt. This agent does not do terrorism, drugs or espionage. Only healthcare fraud.
144586 tn?1284669764
Thew deal is this. If you report through the Qui Tam program, the government will review all his patient records. You will be entitled to a portion of cash for every patient he has defrauded.
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