In a substantial settlement, Dr. Nishi Patel, a Drexel University-educated physician, has agreed to cough up $95,000 to put to rest allegations of defrauding Medicare by ordering a spate of unnecessary genetic tests, the U.S. Attorney's Office disclosed. The allegations against Patel centered around the referral of over 400 patients for genetic testing that was neither medically justified nor predicated on a substantial doctor-patient relationship.
From August 2018 through May 2020, Dr. Patel was accused of exploiting the convenience of telemedicine to make referrals after only brief, and sometimes non-existent, consultations. These tests, which often run into thousands of dollars per patient, were billed to Medicare, piling expenses on an already burdened healthcare system. According to a statement obtained by the Justice Department, U.S. Attorney Jacqueline C. Romero emphasized that "Doctors who refer patients for medically unnecessary and costly services, such as genetic testing, deplete vital funds from Medicare and other government healthcare programs."
This settlement is part and parcel of a broader initiative to clamp down on healthcare fraud which continues to sap crucial funds from government coffers. Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General, Maureen R. Dixon, highlighted the commitment to maintain integrity within Medicare billing practices, stating, “Accurately billing for services provided to Medicare beneficiaries is required of all health care providers.”
Assistant U.S. Attorney Deborah W. Frey, and Auditor Dawn Wiggins were at the helm of this case, utilizing the False Claims Act, a key tool for the government in its fight against fraud in the healthcare sphere. Both officials have reiterated the government's determination to prosecute providers who unnecessarily inflate healthcare costs. “This office will continue to work with law enforcement partners, and our own internal analytics tools, to identify healthcare providers who increase costs through unnecessary procedures,” U.S. Attorney Romero affirmed in the report.
