Leader of $50 Million Health Care Fraud Pleads Guilty

www.Justice.gov,  Press Release, April 26, 2024

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.

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. Continue Press release