Amrish Patel, 62, of Monroe Township, N.J., was responsible for submitting bills for surgeries related to work-related injuries at a New York City-based orthopedic surgery practice, according to a Dec. 9 news release from the New York Attorney General’s Office. Under the terms of his client agreements, Mr. Patel was supposed to submit bills for surgical procedures to insurance carriers — including the New York State Insurance Fund, the workers’ compensation carrier for these claims.
After gaining the trust of the surgeons, Mr. Patel submitted hundreds of falsified claim forms to the New York State Insurance Fund, instructing that certain insurance checks be issued directly to his companies instead of to the physicians. He concealed the scheme — which occurred between January 2012 and January 2019 — by diverting a portion of the total insurance payments to himself. He also forged one of the physicians’ signatures on claim forms.
He pleaded guilty in September to one count of insurance fraud, according to the release. In addition to probation, Mr. Patel was ordered to pay $300,000 in restitution to the surgeons.
