Leader Of $50 Million Health Care Fraud Pleads Guilty
summary
Manishkumar Patel, a leader in a $50 million health care fraud scheme, pleaded guilty to conspiracy to commit health care fraud, wire fraud, and violating the Anti-Kickback Statute for orchestrating t
paragraph
Manishkumar Patel, a leader in a $50 million health care fraud scheme, pleaded guilty to conspiracy to commit health care fraud, wire fraud, and violating the Anti-Kickback Statute for orchestrating the sale of fraudulent prescriptions for durable medical equipment and other supplies to Medicare providers. Between 2019 and 2022, Patel utilized "doctor chasing" tactics and forged scripts to generate illegitimate claims, resulting in nearly $50 million in losses to Medicare while while concealing illegal kickbacks through sham marketing contracts. As part of the resolution, Patel was ordered to pay $48,150,692.49 in restitution to the U.S. Centers for Medicare and Medicaid Services and forfeit $6,839,900. He is scheduled to be sentenced on July 26, 2024, facing a maximum potential sentence of five years in prison for each count.
narrative
Manishkumar Patel, a leader in a $50 million health care fraud scheme, pleaded guilty to conspiracy to commit health care fraud, wire fraud, and violating the Anti-Kickback Statute for orchestrating the sale of fraudulent prescriptions for durable medical equipment and other supplies to Medicare providers. Between 2019 and 2022, Patel utilized "doctor chasing" tactics and forged scripts to generate illegitimate claims, resulting in nearly $50 million in losses to Medicare while while concealing illegal kickbacks through sham marketing contracts. As part of the resolution, Patel was ordered to pay $48,150,692.49 in restitution to the U.S. Centers for Medicare and Medicaid Services and forfeit $6,839,900. He is scheduled to be sentenced on July 26, 2024, facing a maximum potential sentence of five years in prison for each count. Manishkumar Patel, a 44-year-old New York resident, pled guilty to conspiracy to commit health care fraud, wire fraud, and violating the Anti-Kickback Statute for leading a $50 million scheme that fraudulently sold forged prescriptions for durable medical equipment, pharmaceuticals, and lab tests to Medicare providers. Patel obtained prescriptions through “doctor chasing”—using call centers to gather minimal beneficiary data and securing signed orders from physicians who never examined patients—then sold these fraudulent scripts to suppliers who billed Medicare. To conceal kickbacks, Patel and providers used sham marketing contracts, resulting in nearly $50 million in losses to Medicare, with $48.15 million in restitution ordered and $6.84 million in forfeiture. He faces up to five years in prison per count and is scheduled for sentencing on July 26, 2024.
Classified health-care-fraud(confidence 100%). No EDGAR filing fingerprint (criminal/DOJ-side scheme). detection rule →
Parties
damian williamsmanishkumar patelmedicare providers
Keywords
patelmedicarehealth carefraudcare fraudmedicare providerscarehealthmillion healthscriptsmillionlinkleader millionfraud pleadsgovernment non-government
Extracted insights
Dollar amounts 4
- $50.00M $50 Million $10M–$100M
- $50.00M $50 million $10M–$100M
- $48.15M $48,150,692 $10M–$100M
- $6.84M $6,839,900 $1M–$10M
Entities 8
- scheme_term $50 million health care fraud and kickback scheme
- person damian williams
- person manishkumar patel
- scheme_term manishkumar patel in violation of anti-kickback statute
- person medicare providers
- scheme_term sham contracts for generic marketing services to conceal kickback scheme
- scheme_term violating the anti-kickback statute
- scheme_term wire fraud
Triples 15
- Manishkumar Patel pled guilty to conspiracy to commit health care fraud
- Manishkumar Patel pled guilty to wire fraud
- Manishkumar Patel pled guilty to violating the Anti-Kickback Statute
- Manishkumar Patel led $50 million health care fraud and kickback scheme
- Manishkumar Patel fraudulently sold prescriptions and doctors' orders for durable medical equipment between 2019 and 2022
- Manishkumar Patel obtained scripts from call centers that contacted Medicare beneficiaries
- Manishkumar Patel arranged cursory telemedicine appointments with beneficiaries
- Manishkumar Patel sold scripts to Medicare Providers who billed Medicare
- Manishkumar Patel caused losses to Medicare of nearly $50 million
- Manishkumar Patel ordered to pay restitution $48,150,692.49 to U.S. Centers for Medicare and Medicaid Services
- Manishkumar Patel ordered to forfeit $6,839,900
- Manishkumar Patel scheduled to be sentenced July 26, 2024
- Damian Williams announced Manishkumar Patel pled guilty in connection with $50 million health care fraud
- Medicare Providers made payments to Manishkumar Patel in violation of Anti-Kickback Statute
- Manishkumar Patel and Medicare Providers entered into sham contracts for generic marketing services to conceal kickback scheme
Extracted body text (4,396c)
Press Release Leader Of $50 Million Health Care Fraud Pleads Guilty Friday, April 26, 2024 Share FacebookLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. XLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. LinkedInLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. Email For Immediate Release U.S. Attorney's Office, Southern District of New York Damian Williams, the United States Attorney for the Southern District of New York, announced that MANISHKUMAR PATEL pled guilty today in connection with a $50 million health care fraud and kickback scheme involving the sale of fraudulent prescriptions for durable medical equipment, among other medical supplies, to suppliers, pharmacies, and laboratories who obtained payment for those fraudulent prescriptions from Medicare. PATEL pled guilty before U.S. Magistrate Judge Ona T. Wang and is scheduled to be sentenced on July 26, 2024, at 10:00 a.m. before U.S. District Judge Lorna Schofield. U.S. Attorney Damian Williams said: “Behind every dollar siphoned through fraud lies a patient denied rightful care. Manishkumar Patel cost Medicare nearly $50 million in resources that could have been used to provide genuine care to those in need. His guilty plea today is a step toward restoring integrity and trust in our health care system.” According to the charging documents and other filings and statements made in court: Between 2019 and 2022, PATEL and a co-conspirator (“CC-1”) fraudulently sold prescriptions and doctors’ orders for durable medical equipment, pharmaceuticals, and laboratory tests (collectively, “scripts”) to durable medical equipment suppliers, pharmacies, and laboratories (collectively, the “Medicare Providers”). PATEL obtained the scripts from call centers that called Medicare beneficiaries and asked them perfunctory questions designed to justify a script that would be reimbursed by Medicare. PATEL turned the information from those calls into scripts by arranging cursory telemedicine appointments with the beneficiaries — a practice called “doctor chasing,” in which the information was sent to a doctor who signed the script without seeing the patient and who was frequently unaware of what they were signing — and obtaining forged scripts. PATEL then sold the scripts to Medicare Providers, which filled the orders and billed Medicare. Because the scripts were fraudulently obtained, many beneficiaries rejected the items they were sent by the Medicare Providers, many doctors threatened to report PATEL for fraud, and Medicare frequently refused to pay for the scripts. The Medicare Providers made payments to PATEL for the scripts in violation of the Anti-Kickback Statue. PATEL and the Medicare Providers entered into sham contracts for generic marketing services at flat rates in an attempt to conceal their illegal kickback scheme. PATEL was a leader of the scheme, which resulted in losses to Medicare of nearly $50 million. * * * PATEL, 44, of Pelham Manor, New York, pled guilty to one count of conspiracy to commit health care fraud, one count of wire fraud, and one count of violating the Anti-Kickback Statute, each of which carries a maximum sentence of five years in prison. In addition, PATEL was ordered to pay $48,150,692.49 in restitution to the U.S. Centers for Medicare and Medicaid Services and forfeit $6,839,900. The maximum potential sentences in this case are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendant will be determined by a judge. Mr. Williams praised the outstanding work of the Department of Health and Human Services, Office of Inspector General. The case is being prosecuted by the Office’s Complex Frauds and Cybercrime Unit. Assistant U.S. Attorney Kevin Mead is in charge of the prosecution. Contact Nicholas Biase, Lauren Scarff, Shelby Wratchford (212) 637-2600 Updated April 26, 2024 Topic Healthcare Fraud Component USAO - New York, Southern Press Release Number: 24-149
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Press Release Leader Of $50 Million Health Care Fraud Pleads Guilty Friday, April 26, 2024 Share FacebookLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. XLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. LinkedInLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. Email For Immediate Release U.S. Attorney's Office, Southern District of New York Damian Williams, the United States Attorney for the Southern District of New York, announced that MANISHKUMAR PATEL pled guilty today in connection with a $50 million health care fraud and kickback scheme involving the sale of fraudulent prescriptions for durable medical equipment, among other medical supplies, to suppliers, pharmacies, and laboratories who obtained payment for those fraudulent prescriptions from Medicare. PATEL pled guilty before U.S. Magistrate Judge Ona T. Wang and is scheduled to be sentenced on July 26, 2024, at 10:00 a.m. before U.S. District Judge Lorna Schofield. U.S. Attorney Damian Williams said: “Behind every dollar siphoned through fraud lies a patient denied rightful care. Manishkumar Patel cost Medicare nearly $50 million in resources that could have been used to provide genuine care to those in need. His guilty plea today is a step toward restoring integrity and trust in our health care system.” According to the charging documents and other filings and statements made in court: Between 2019 and 2022, PATEL and a co-conspirator (“CC-1”) fraudulently sold prescriptions and doctors’ orders for durable medical equipment, pharmaceuticals, and laboratory tests (collectively, “scripts”) to durable medical equipment suppliers, pharmacies, and laboratories (collectively, the “Medicare Providers”). PATEL obtained the scripts from call centers that called Medicare beneficiaries and asked them perfunctory questions designed to justify a script that would be reimbursed by Medicare. PATEL turned the information from those calls into scripts by arranging cursory telemedicine appointments with the beneficiaries — a practice called “doctor chasing,” in which the information was sent to a doctor who signed the script without seeing the patient and who was frequently unaware of what they were signing — and obtaining forged scripts. PATEL then sold the scripts to Medicare Providers, which filled the orders and billed Medicare. Because the scripts were fraudulently obtained, many beneficiaries rejected the items they were sent by the Medicare Providers, many doctors threatened to report PATEL for fraud, and Medicare frequently refused to pay for the scripts. The Medicare Providers made payments to PATEL for the scripts in violation of the Anti-Kickback Statue. PATEL and the Medicare Providers entered into sham contracts for generic marketing services at flat rates in an attempt to conceal their illegal kickback scheme. PATEL was a leader of the scheme, which resulted in losses to Medicare of nearly $50 million. * * * PATEL, 44, of Pelham Manor, New York, pled guilty to one count of conspiracy to commit health care fraud, one count of wire fraud, and one count of violating the Anti-Kickback Statute, each of which carries a maximum sentence of five years in prison. In addition, PATEL was ordered to pay $48,150,692.49 in restitution to the U.S. Centers for Medicare and Medicaid Services and forfeit $6,839,900. The maximum potential sentences in this case are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendant will be determined by a judge. Mr. Williams praised the outstanding work of the Department of Health and Human Services, Office of Inspector General. The case is being prosecuted by the Office’s Complex Frauds and Cybercrime Unit. Assistant U.S. Attorney Kevin Mead is in charge of the prosecution. Contact Nicholas Biase, Lauren Scarff, Shelby Wratchford (212) 637-2600 Updated April 26, 2024 Topic Healthcare Fraud Component USAO - New York, Southern Press Release Number: 24-149