Manishkumar Patel of Pelham Manor, NY recently pleaded guilty in connection with a healthcare fraud and kickback scheme involving the sale of fraudulent prescriptions to pharmacies, durable medical equipment suppliers, and laboratories, which then obtained payments from Medicare. The scheme resulted in $50 million in fraudulent claims from 2019-22.
Patel and a co-conspirator worked with call centers that contacted Medicare beneficiaries and asked them a simple series of questions designed to gather information sufficient to justify a script reimbursable by Medicare. He then sent that information to doctors who would sign scripts without seeing the patients, and then sold the scripts to Medicare providers which filled the orders and billed Medicare. The providers’ payments to Patel for the scripts violated the federal Anti-Kickback Statute (AKS), and Patel and the providers created phony contracts for marketing services to hide the scheme.
Patel pleaded guilty to one count of conspiracy to commit healthcare fraud, one count of wire fraud, and one count of violating the AKS, each of which can bring him five years in jail when he is sentenced on July 26. He was further ordered to pay over $48 million in restitution and to forfeit over $6.8 million.
Sign up to receive Rivkin Rounds at www.RivkinRounds.com.