Jay Clayton, the United States Attorney for the Southern District of New York, announced that Manishkumar Patel was sentenced to 14 months in prison for defrauding Medicare. In addition to the prison term, Patel, 44, was sentenced to one year of home detention. He was also ordered to pay $48,150,692.49 in restitution to the US Centers for Medicare and Medicaid Services, and to forfeit $6,839,900. Between 2019 and 2022, Patel and a coconspirator fraudulently sold prescriptions and doctors’ orders for durable medical equipment, pharmaceuticals, and laboratory tests (collectively, “scripts”) to durable medical equipment suppliers, pharmacies, and laboratories (collectively, the “Medicare Providers”). Patel obtained the scripts from call centers that called Medicare beneficiaries and asked them perfunctory questions designed to justify a script that would be reimbursed by Medicare. Patel turned the information from those calls into scripts by, variously: arranging 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; and obtaining forged scripts. He then sold the scripts to Medicare Providers, which filled the orders and billed Medicare.
Because the scripts were fraudulently obtained, many beneficiaries rejected the items they were sent by the Medicare Providers, many doctors threatened to report Patel for fraud, and Medicare frequently refused to pay for the scripts. The Medicare Providers made payments to Patel for the scripts in violation of the Anti-Kickback Statute. 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. Patel was a leader of the scheme, which resulted in losses to Medicare of approximately $48 million.