The podiatrist from Virginia who pled guilty in January to participating in a Medicare fraud scheme involving bone growth stimulators, is going to jail.
Ilene Terrell, D.P.M., was sentenced to five months in prison, five months of home confinement and two years of supervised release on April 17, 2014. She was also ordered to pay a $15, 000 fine.
The Lie After the Fact
Specifically, Terrell was sent to jail, not for her part in falsifying patient medical records and prescribing an Orthofix, Inc. bone growth stimulator where the claim would not have met Medicare’s guidelines, but for lying about it to a federal grand jury.
Falsified Patient Records
According to the U.S. Attorney’s Office in Boston, when Terrell prescribed a stimulator that didn’t meet Medicare’s guidelines, the Orthofix territory manager, Terrell, and an employee at Terrell’s direction often falsified the patient’s medical records, making it appear as though the stimulator was not prescribed until three months had elapsed without healing, when in fact that was not true and Medicare should not have paid the claim.
For instance, they deleted references in chart notes that the patient was using the stimulator and was healing, and they created new, fictitious notes at the end of the 90-day period stating that the bone was still broken and that a stimulator would be ordered. Terrell also created fictitious prescriptions and signed Medicare Certificates of Medical Necessity falsely stating that she had ordered the stimulator at the end of the 90-day window, when in fact the patient had received the device months previously. These medical records were altered solely to ensure that Medicare paid Orthofix for bone stimulator claims that did not satisfy the program’s payment rules.
Grand Jury Testimony
When Terrell testified before a grand jury in May 2012, she was asked if she was aware that patient records had been manipulated. She said no. When asked about her communications with an Orthofix representative about the government’s investigation, she lied about that too. The U.S. Attorney said Terrell discussed the government’s investigation at length with the Orthofix representative and instructed him “you and I have not talked.” She also threatened him, stating, “If you guys take me out you are never going to live to hear the end of it. If I roll on this, I am serious, heads are going to roll, heads are absolutely gonna roll.”
After she learned that her practice administrator of 23 years had provided truthful testimony to the grand jury, she fired the employee.
Bone-Stim Prison Score
Seven other individuals have already been sentenced to short prison terms or home confinement as a result of the government’s investigation. One former Orthofix territory manager has agreed to plead guilty to healthcare fraud. Orthofix paid approximately $42 million in criminal fines and civil payments and was sentenced to five years of probation. Current management took over Orthofix after the settlement with the Justice Department.
According to Terrell’s web site, “The Foot Doctor of Rappahannock, Ltd., ” she is board certified in foot surgery by the American Board of Podiatric Surgery. She provides conservative as well as surgical management of foot and ankle ailments for children, teens, adults and seniors, including diabetic patients.
She has been practicing in the Fredericksburg area since 1986 and has maintained board certification in foot surgery since 1995. Terrell maintains privileges at Mary Washington Hospital and the Fredericksburg Ambulatory Surgery Center. She has served as chairman of the podiatry department at Mary Washington Hospital.
Terrell attended the Pennsylvania College of Podiatric Medicine and the Surgical Residency programs. “She is committed to providing the highest level of care, taking the time to explain your ailment and address your concerns. She believes that ongoing training and product knowledge assists her in her efforts to remain current with new trends in podiatric medicine and surgery, ” stated the web site.
