Michael J. McKay, Medicare Fraud, Massachusetts 2012

BOSTON, MA – In a shocking case of healthcare fraud, a former Orthofix territory manager was sentenced to one year of probation, with the first three months to be served in home confinement, and ordered to forfeit $10,000 and pay a fine of $3,000 for defrauding Medicare by forging patient medical records.

Michael J. McKay, 32, pleaded guilty to healthcare fraud in May 2012 and was sentenced by U.S. District Court Judge Denise J. Casper yesterday. McKay was a territory manager for Orthofix, a company that manufactured and distributed bone growth stimulator medical devices, between 2008 and 2009.

According to the investigation, McKay frequently falsified the patients’ medical records to make it appear as though the order met Medicare’s rules so that Medicare would pay for a claim that otherwise would not be covered. Between 2008 and 2010, federal insurance carriers paid more than $70,000 for bone growth stimulators for claims where McKay falsified medical records.

McKay altered physician’s chart notes, changing the dates of patient visits, describing patient visits that did not occur, and inserting false diagnoses. McKay also forged prescriptions and Medicare Certificates of Medical Necessity within the orders. Orthofix fired McKay after it discovered his fraud.

Even after he was fired, McKay continued to submit orders for stimulators by submitting them to a colleague, Derrick Field, who split the commissions with Field. Field was sentenced to five months home confinement, two years of probation, and $44,000 in fines and forfeiture in January 2013.

The Orthofix investigation has resulted in a number of felony charges against employees and contractors of Orthofix, including the former vice president of sales, Tom Guerrieri, who was sentenced to eight months in prison and ordered to pay $50,000 in fines and forfeiture in January 2013.

Other defendants, including Michael Cobb, a physician’s assistant, and Brian Racey, a territory manager, are scheduled to be sentenced in the coming months. The case was investigated by the U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations; the Federal Bureau of Investigation Boston Field Division; and the Department of Defense, Defense Criminal Investigative Service – Boston Resident Agency.

Related Federal Cases