A Lorain County man has been sentenced to prison for his role in a healthcare billing conspiracy scheme that was intended to fraudulently bill Medicare for more than $14.5 million.
Timothy Sutton, 44, of North Ridgeville, Ohio, was sentenced to 64 months (5 years and 4 months) in prison by U.S. District Judge David A. Ruiz, after he pleaded guilty in April 2025 to conspiracy to commit wire fraud and mail fraud, false statements related to health care matters, and aggravated identity theft.
He was also ordered to serve 3 years of supervised release and pay nearly $6 million in restitution to the U.S. Department of Health and Human Services. Judge Ruiz imposed the sentence Jan. 12.
“Mr. Sutton deliberately lied about performing patient examinations and then used his role as a trusted medical professional to line his pockets at the expense of taxpayers. We will not tolerate those who utilize their positions of authority to defraud Medicare, or any government agency,” said United States Attorney David M. Toepfer for the Northern District of Ohio.
According to court documents, Sutton used his position as a licensed medical doctor in the state of Ohio to cause submission of claims on behalf of patients who did not need the medical treatment. He was employed by two telemedicine companies based in Florida which provided him with pre-completed orders for durable medical equipment (DME), such as braces, and/or cancer genetic testing (CGX) for him to approve and digitally sign.
In doing so, he affirmed that he had examined each patient using a telemedicine platform and then determined that they needed DME. He also falsely affirmed that he was the treating physician of the patients who he had signed orders to receive CGX testing. However, federal investigators found that Sutton never examined any of the patients whom he claimed to have examined.
Related Federal Cases
- Willie Weatherspoon, Money Laundering, Florida 2024 · Washington
- Morales Cacique, Money Laundering, Florida 2016 · Washington
- Edgar Perez, Healthcare Fraud, Florida 2023 · Texas
- Ahmed A. Sh. Ahmed, Wire Fraud and False Statements, Ohio, 2023 · Ohio
- Russell W. Spitz, Bank and Wire Fraud, Ohio, 2023 · Ohio
Key Facts
- State: Ohio
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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