A Pelham Manor executive has been sentenced to prison for 14 months for leading a health care scam that cost Medicare $48 million.
U.S. District Judge Lorna G. Schofield also ordered Manishkumar Patel, 45, to pay back Medicare and to forfeit $6.8 million in ill-gotten gains, on May 6 in U.S. District Court, Manhattan. He has to serve three years of supervision after he is released from prison, including a year of home confinement with electronic monitoring, and provide 1,000 hours of community service.
Patel pleaded guilty to conspiracy to commit health care fraud, wire fraud, and violation of an anti-kickback law.
From 2019 to 2022, Patel and associate Nagaindra Srivastav used international call centers to solicit personal information from people eligible for Medicare. Then they used the details to create prescriptions for medical equipment, drugs and tests.
They got doctors to sign the scripts, or in some cases forged doctors’ signatures. They sold the bogus prescriptions to medical equipment providers, pharmacies and labs. And they created sham contracts that disguised kickbacks as payments for marketing services.
Businesses that bought the bogus prescriptions billed Medicare.
The conspirators created tens of thousands of fraudulent prescriptions and leads, according to court records. Medicare was billed for $160 million and approved nearly $48.2 million.
In 2023, Srivastav, who was prosecuted in Atlanta, was sentenced to a 9-year prison sentence that was later reduced to 6 years.
Patel was born in a village near Mumbai, India, was recognized as a gifted student, eventually earned a master’s degree in business administration from City University of London, emigrated to the U.S. in 2012, and built a direct sales business in energy and telecommunications, according to a sentencing memo his attorneys submitted to the judge.
They recommended no prison time, and a period of either probation or home confinement.
They attributed Patel’s criminal behavior to autism, “the profound developmental, psychological and social impairments that permeate every aspect of his life,” that was diagnosed this past December.
“Plainly put, Mr. Patel was no Al Capone,” his lawyers advised the judge. “Rather, he was a naïve and undiagnosed autistic male who, after some 20 years of law-abiding business activity, found himself involved in a scheme that’s today appears almost inexplicable.”
They claimed that Patel was susceptible to manipulation by others, and even after he recognized that his conduct was unlawful, he felt stuck, with misplaced concepts of duty and loyalty, and without the psychological tools to extricate himself from the situation.
They said Patel made about $15 per prescription, for a total of $240,000 out of the $48 million Medicare paid to the buyers of phony prescriptions.
Patel has paid back $20,000 to Medicare so far. He has given the government 14 names of potential fraud targets. He is getting medical help and is committed to “flying straight.” He is unlikely to commit another crime, his lawyers argued.
“Mr. Patel is fundamentally a decent person,” according to his lawyers. “He should not be defined by the impaired conduct for which he has accepted responsibility.”
Assistant federal prosecutor Kevin Mead recommended 5 years in prison.
He did not dispute the autism diagnosis, in his sentencing recommendation, but he said Patel’s case is not particularly severe. His role as a leader in the scheme and his record as a well-educated businessman suggest that he was not substantially impaired.
Patel controlled the call centers that were used to generate Medicare leads, and he conducted the fraud through his company, Kimberly Hathaway Corp., and through shell companies he controlled.
His bank accounts show that he received more than $6.8 million from the scheme. And though Patel said most of that money was sent abroad to a co-conspirator, he has not provided evidence to substantiate his claim.
He lives in a $1.2 million house, and when he was arrested in 2023 investigators found $370,000 in cash there.
Patel and his co-conspirators frequently shared U.S. Department of Justice press releases about similar health care crimes, Mead said. So he knew he could be prosecuted yet was not deterred.
“There is no doubt that the defendant committed the fraud because of greed,” Mead advised the judge. “He ripped off the government so that he could personally profit.”
Judge Schofield ordered Patel to surrender to the Bureau of Prisons on Aug. 1.
