Manishkumar Patel, a New York man, has been sentenced to 14 months behind bars for masterminding a scheme that defrauded Medicare out of nearly $50 million, announced Jay Clayton, the U.S. Attorney for the Southern District of New York. In a case highlighting the vulnerability of healthcare systems to fraud, Patel, 44, of Pelham Manor, was also given one year of home detention, and he must also pay a staggering $48,150,692.49 in restitution, with an additional forfeiture of $6,839,900.
The scheme, unfolded between 2019 and 2022, involved the sale of unnecessary prescriptions and doctors' orders for various medical supplies and services to suppliers and pharmacies who then billed Medicare, according to a statement from the U.S. Attorney's Office. Patel, obtaining scripts from call centers after they conducted sham interviews with Medicare beneficiaries, engaged in activities such as "doctor chasing" and even securing forged prescriptions to keep this lucrative scheme in motion.
The fraudulent nature of the scheme meant that many of the healthcare items were rejected by beneficiaries, while doctors associated with these prescriptions threatened to blow the whistle on Patel's operation. Despite their efforts, the Medicare system still suffered significant financial losses.
In addition to the prison sentence, court documents state that Patel used sham contracts to conceal kickbacks, illustrating the methods employed to disguise illegal proceeds. The U.S. Department of Health and Human Services, Office of Inspector General, identified the scheme, receiving recognition from Mr. Clayton for their work. Assistant U.S. Attorney Kevin Mead is leading the prosecution from the Office’s Complex Frauds and Cybercrime Unit.
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