Feds charge Westchester businessman in $10M healthcare fraud scheme

WHITE PLAINS — A 44-year-old Westchester County businessman faces federal charges contending he made at least $10 million in fraudulent healthcare claims.

The indictment charges Manishkumar Patel of Pelham Manor with elaborate healthcare fraud and a kickback scheme involving the sale of fraudulent prescriptions. according to the U.S. Attorney's Office for the Southern District of New York.

Authorities arrested Patel on Tuesday morning in Pelham Manor. U.S. District Court Magistrate Judge Gary Stein arraigned Patel several hours later on the five-count indictment.

U.S. Attorney Damian Williams said the grand jury indictment contends that between 2019 and 2022, Patel and an unnamed co-conspirator fraudulently sold prescriptions and doctors’ orders for durable medical equipment, pharmaceuticals, and laboratory tests. They sold the prescriptions to Medicaid providers.

"As alleged, Manishkumar Patel ran a scheme to get rich by generating fraudulent prescriptions used to bill Medicare for millions of dollars in unnecessary healthcare expenses," Williams said in a release.

Patel was released on a $1 million personal recognizance bond secured by a home owned by his wife. His case has been adjourned until Nov. 30.

Patel faces a statutory prison sentence of up to 20 years each on conspiracy to commit health care fraud and wire fraud. He could face five years for conspiracy to violate the federal Anti-Kickback Statute, which prohibits making money by referring business that is reimbursable by federal health care programs.

Feds describe fraudulent prescription scheme

Williams outlined the scheme in the release:

Patel obtained the prescriptions from call centers that called Medicare beneficiaries and asked them perfunctory questions designed to justify a script that would be reimbursed by Medicare.

Patel would then hold 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.

Patel is accused of selling the forged prescription to Medicare providers, which billed Medicare.

Williams said that because the scripts were deemed fraudulently, many beneficiaries rejected the items, many doctors threatened to report Patel for fraud, and Medicare frequently refused to pay for the scripts.

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.

Special Agent in Charge Naomi Gruchacz said such scams can raise the costs of health care for people.

“Certain violations of the Anti-Kickback Statute can result in the inducement of medically unnecessary durable medical equipment, medications, and laboratory tests, which can affect the availability of services for others and drive up the cost of health care for everyone," she said.

The case is being prosecuted by the U.S. Attorney's Office Complex Frauds and Cybercrime Unit. Assistant U.S. Attorney Kevin Mead is in charge of the prosecution. Federal prosecutors worked on the investigation with the U.S. Health and Human Services Inspector General's Office.

More: Chestnut Ridge businessman faces federal prison for $127M healthcare fraud kickback scheme

Sentencing near in Rockland fraud case

In a similar case, a Rockland County marketing company owner recently pleaded guilty to federal charges involving a multi-million dollar healthcare fraud kickback scheme.

Eric Karlewicz, aka “Anthony Mazza,” and his conspirators submitted false and fraudulent claims to healthcare benefit programs totaling more than $127 million for durable medical equipment, according to the U.S. Attorney's Office in Newark, New Jersey.

At his scheduled sentencing on Feb. 20, 2024, Karlewicz faces up to 10 years in prison for conspiracy to violate the federal Anti-Kickback Statute and conspiracy to commit health care fraud.

Steve Lieberman covers government, breaking news, courts, police, and investigations. Reach him at slieberm@lohud.com. Twitter: @lohudlegal.

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This article originally appeared on Rockland/Westchester Journal News: Westchester NY businessman charged in $10M healthcare fraud scheme