Manishkumar Patel pleaded guilty in connection with a $50 million healthcare fraud and kickback scheme involving the sale of fraudulent prescriptions for durable medical equipment (DME), among other medical supplies, to suppliers, pharmacies, and laboratories who obtained payment for those fraudulent prescriptions from Medicare. 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 DME, pharmaceuticals, and laboratory tests (collectively, “scripts”) to DME 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.
