A Pelham Manor man has been indicted on fraud and kickback charges for allegedly defrauding Medicare of $10 million.
Manishkumar Patel, 44, was arrested at home at 6:00 a.m. on Oct. 31 and arraigned before U.S. Magistrate Judge Gary Stein in federal court in Manhattan. He pled not guilty to five charges and posted a $1 million bond secured by his wife’s house.
Patel and several co-conspirators who are not identified in the indictment allegedly devised a three-part scheme to create phony prescriptions and doctors’ orders for medical equipment, laboratory tests and pharmaceuticals from 2019 to 2022.
First, they used call centers to contact people covered by Medicare to develop “leads.” Callers would ask perfunctory questions to justify a prescription for medical items that could be reimbursed by Medicare.
Patel controlled at least one of the call centers, according to the indictment, and paid other centers for leads.
Second, they turned leads into prescriptions. Sometimes they did cursory telemedicine appointments with the Medicare beneficiaries, according to the indictment. Sometimes they forged a doctor’s signature on prescriptions. Other times they got doctors to sign prescriptions without examining the patient or reviewing sufficient information to establish a medical necessity.
Third, they allegedly sold phony prescriptions to medical equipment providers, pharmacies and labs by using sham contracts to receive kickbacks disguised as payments for marketing services.
On Nov. 1, 2019, for instance, a medical provider paid Patel $11,250 for doctored prescriptions, according to the indictment.
The buyers, who are not identified in the indictment, received about $10 million in reimbursements from Medicare for items such as prosthetics and knee braces.
The indictment does not say how much money Patel allegedly made from kickbacks.
The scheme did not necessarily go smoothly.
Medicare patients complained to equipment providers that they had never ordered the devices.
A doctor faxed back a prescription to Patel with the word “fraud” written across it.
A conspirator wrote to Patel that “physicians are calling them and threatening to report a Medicare fraud.”
A second conspirator who controlled a pharmacy and medical equipment business wrote to Patel: “I have received tons of letters from CMS (Centers for Medicare & Medicaid Services) and it doesn’t look good. … Remember we have always talked about we like to sleep at night. Since all this marketing problems I haven’t been able to sleep properly.”
A third conspirator wrote to Patel that Medicare had rejected more than half of the prescriptions. “You dumped a bunch of crap on us and even [name redacted] said not to use it.”
Patel was charged with conspiracies, health care fraud, wire fraud and taking kickbacks.
His attorney, Richard Palma, did not reply to a message requesting Patel’s responses to the allegations.
The case was investigated by the U.S. Health and Human Services inspector general’s office and is being handled by assistant federal prosecutor Kevin Mead of the Complex Frauds and Cybercrime Unit.
