Florida pharmacy owner ordered to pay $865K over insurance fraud scheme

A Kentucky federal court has sentenced Florida pharmacy owner Nitesh Patel to 12 months’ probation and 12 months of home confinement and ordered him to pay more than $865,000 in restitution following his November guilty plea to one count of conspiracy to commit healthcare fraud. 

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In addition to the restitution, the order includes a $10,000 fine and forfeiture of an additional $100,000. Mr. Patel paid the restitution and forfeiture monies at his sentencing, according to a June 6 news release.

A Labor Department investigation found that between November 2014 and June 2018, Mr. Patel engaged in a healthcare fraud scheme with a Louisville, Ky., physician. Mr. Patel would fraudulently bill commercial and public payers, including Medicare and Tricare, with overinflated prescription drug prices. Payers would then reimburse his business, Clearwater, Fla.-based Assured RX, with higher rates. 

Mr. Patel’s sentencing was part of a larger Justice Department crackdown on unlawful opioid distribution, kickbacks and fraud in the Appalachian region. In 2019, the agency charged 60 people, including 53 medical professionals across seven states, with the illegal prescription and distribution of opioids and with healthcare fraud.

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