Federal sentence follows hundreds of brace orders signed without patient exams
A former New Hampshire psychiatrist and former hospital chief medical officer has been sentenced to 12 months and a day in federal prison after pleading guilty to health care fraud tied to a Medicare brace scheme. Steven Powell, MD, 56, now lives in Georgia and was also ordered to pay $761,202.75 in restitution to Medicare after signing hundreds of medically unnecessary brace orders without examining or speaking with the patients named in them.
The sentence closes a case built around a narrow but deeply consequential breach of clinical responsibility: a physician’s signature used as a billing instrument rather than a medical judgment. In practice, durable medical equipment fraud depends on the appearance of legitimacy. A pre-populated form, a hurried signature, and a physician identifier can be enough to convert unsupported claims into reimbursable charges, even when no real patient assessment occurred.
Pre-populated orders, fabricated records, and a Medicare billing pipeline
Between December 2018 and March 2019, Powell signed pre-populated orders for knee, wrist, back, and shoulder braces for more than 500 Medicare beneficiaries. Court records cited in the case show that he often approved several braces per patient. He did so without conducting examinations or conversations with the patients whose names appeared on the paperwork.
One detail captures the speed and emptiness of the process. Powell completed more than 100 pages requiring 75 signatures in just over a minute. In that packet, he signed orders for four braces for a 77-year-old beneficiary who was immobile during the last year of life and had never met him. A clinical signature is supposed to document individualized judgment. Here, it functioned as a production line output.
The scheme relied on a telemedicine company, Expansion, which generated fabricated medical records and transmitted them to Powell through DocuSign. He was paid $15 per consult to sign orders falsely stating that he had assessed or treated the patients. Expansion then sold the orders to DME suppliers, which submitted about 1,400 false claims totaling more than $1.9 million. Medicare paid $761,203 of that amount.
Those numbers matter because the harm in this type of fraud is not abstract accounting. Braces are not harmless pieces of paperwork. They are billed as medical devices justified by symptoms, functional limitations, and a clinician’s evaluation. When those clinical predicates are invented, the system pays for care that never occurred and exposes beneficiaries to unnecessary equipment, administrative confusion, and the erosion of trust in remote prescribing models.
A physician’s authority used as commercial cover
Powell had served as chief medical officer of New London Hospital in New Hampshire from April 2012 until May 2018. The hospital said in a statement to Becker’s that the criminal case did not concern his time at the institution. The federal case focused on conduct that occurred later, during the brace-ordering period that ended in March 2019.
The professional role adds a harder edge to the case. A chief medical officer carries institutional authority and is expected to defend the integrity of clinical standards, not dilute them. When that authority is repurposed to validate automated paperwork, the damage extends beyond one physician’s misconduct. It weakens the reliability of remote-order systems and raises the stakes for every payer and supplier chain that depends on physician attestation.
Prosecutors had sought an 18-month sentence. U.S. District Judge Paul Barbadoro recommended that Powell serve his sentence at the lowest possible custody level and as close to his family as possible. He must report to prison on Nov. 13.
Telemedicine DME fraud has become a federal enforcement target
Expansion’s owner, Steven Richardson, was sentenced in August to two years in federal prison in a related $110 million telemedicine DME fraud scheme. Powell’s case sits inside that broader enforcement picture, in which telemedicine infrastructure has been exploited to mass-produce orders for braces and other durable medical equipment without meaningful patient contact.
The structure of the fraud is clinically familiar even if the scale is not. Remote care can improve access when it is used for real evaluation, follow-up, and documentation. It becomes dangerous when telemedicine is reduced to a signature factory. In that setting, the clinical relationship disappears, and the documentation is reverse-engineered to satisfy billing requirements rather than patient need.
Courts and prosecutors are treating those arrangements as more than paperwork offenses. They are billing crimes rooted in false medical necessity claims. The federal response in this case reflects a broader effort to police the gap between legitimate remote care and arrangements that use the language of medicine to conceal commercial fraud.
The restitution order, prison sentence, and delayed sentencing all mark the end of one case, but the facts leave a sharper question about system design: how many physician signatures can be generated before oversight fails, and how much clinical trust is lost when a Medicare beneficiary’s name becomes just another line on a pre-filled form?