Leader of $48M Medicare fraud scheme sentenced to prison

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A New York man was sentenced to 14 months in prison for leading a $48 million Medicare fraud scheme. 

Five things to know:

1. Manishkumar Patel, 44, of Pelham Manor, was sentenced after pleading guilty to conspiring to commit health care fraud, wire fraud, and violating the Anti-Kickback Statute, according to a May 6 Justice Department news release.

2. From 2019 to 2022, Mr. Patel and a co-conspirator fraudulently sold physicians’ orders for durable medical equipment, pharmaceuticals and laboratory tests. 

3. He obtained the scripts from call centers that contacted Medicare beneficiaries and asked them questions designed to justify a script that would be reimbursed by Medicare. He then turned the information from those calls into scripts and sold them to Medicare providers, who filled the orders and billed Medicare. 

4. Medicare lost more than $48 million as a result of the scheme.

5. Mr. Patel was also ordered to pay more than $48 million in restitution and forfeit more than $6.8 million. 

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