Indian-American gets four years jail term for healthcare fraud

An Indian-American physical therapist assistant has been sentenced to over four years in prison and ordered to pay USD 1.9 million in restitution for his role in a USD 14.9 million health insurance fraud scheme.
Jigar Patel, 31, a physical therapist assistant of Michigan was sentenced yesterday to 50 months in prison by US District Judge Terrence Berg for his role in billing federal health insurance programmes for home health services that were never provided.
In addition to his prison term, Patel was asked to pay USD 1.9 million in restitution for the healthcare fraud in which he provided beneficiaries with prescriptions for unnecessary painkillers and other narcotics to induce them to sign false medical documents to support the fraudulent billings, Assistant Attorney General Leslie Caldwell of the Justice Department's Criminal Division said in a statement.

Patel, along with co-defendants Srinivas Reddy, 38, an unlicensed doctor and Shahzad Mirza, 43, a physical therapist both from Michigan were each convicted by a federal jury in April this year of one count of conspiracy to commit health care fraud.
In addition, Mirza and Patel were found guilty of two counts of health care fraud, and Reddy was found guilty of three counts of health care fraud and they will be sentenced at a later date.
Meanwhile, Patel was also found guilty of one count of money laundering.

As a result of the defendants' fraudulent conduct, Medicare paid nearly USD 15 million.

According to evidence presented at trial, between July 2008 and September 2011, the defendants used four home health care companies to fraudulently bill Medicare for home health care services that were never provided.
The defendants used these companies to pay kickbacks to recruiters for the referral of Medicare beneficiaries. In turn, the recruiters paid the beneficiaries cash and promised them access to unnecessary prescriptions for painkillers and other narcotics.
Through a fifth company, the defendants employed unlicensed individuals, including Reddy, to provide the beneficiaries with the promised prescriptions and to obtain the necessary information to complete the referrals for medically unnecessary home health care services.

Evidence presented at trial showed that beneficiaries signed blank medical paperwork that Patel and others then completed with false information to show that care was provided, when it was not.
In the course of the conspiracy, Patel incorporated his own staffing company through which he laundered proceeds of the fraud.