An Ohio doctor 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 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 on Jan. 12.
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.
“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. “Thanks to the Department of Health and Human Services and the Cleveland FBI’s thorough investigations, we have put a stop to this rampant fraud and abuse of power.”
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 for whom 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.
“Violating a position of trust and abusing the privilege of serving as a healthcare provider by willfully defrauding the government and other entities for personal gain is cruel and calculating,” said FBI Cleveland Special Agent in Charge Gregory Nelsen. “When funds from programs like Medicare are not used as intended, taxpayers and people who are entitled to those funds suffer. The FBI will continue its commitment to work with our federal, state, and local partners to investigate criminals like Mr. Sutton and ensure that federally funded healthcare programs are not abused by providers.”
Once Sutton prescribed medical equipment or ordered testing through the telemedicine companies who had hired him, the orders were then either forwarded to other medical businesses, which were part of the conspiracy, or sold to other medical entities.
“When a physician knowingly violates their oath and exploits patients for personal financial gain, it erodes the very foundation of trust in our health care system,” said Mario M. Pinto, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG remains committed to working with our law enforcement partners to safeguard taxpayer dollars and ensure that those who abuse these vital programs are held accountable.”
This case was investigated by the U.S. Department of Health and Human Services-Office of the Inspector General, and the FBI Cleveland Division.
Assistant United States Attorney Michael L. Collyer prosecuted the case.
To submit a complaint about healthcare fraud or abuse of services, visit oig.hhs.gov/fraud/report-fraud.