Indian-American doctor admits healthcare fraud conspiracy
New York, (IANS) An Indian-American physician has accepted submitting false claims for medications that were not medically necessary to defraud the state and local health benefit programs in New Jersey and other insurers.
In response to a superseding charge charging him with one count of conspiracy to commit healthcare fraud, Saurabh Patel, 51, of Newark, entered a guilty plea last Thursday via videoconference before US District Judge Robert B. Kugler.
Saurabh, of Woodbridge, New Jersey, had previously been charged with conspiring in the healthcare fraud scheme with a family member, Kaival Patel, in an indictment.
Despite having no background in pharmaceuticals or medicine, Kaival and his wife established and ran ABC Healthy Living LLC. To market medical products and services, including compound prescription medications, according to court documents.
Kaival and an accomplice then approached Saurabh and persuaded him to authorize prescriptions for compound medications for which they received commissions regardless of whether or not those prescriptions were medically necessary.
According to a Department of Justice statement, the conspirators directed individuals who were paid to receive the compound medications to Saurabh’s medical practice to obtain his authorization on the fraudulent prescriptions.
This allowed Saurabh to receive insurance reimbursement for those patient visits and procedures. In addition to directing people to Saurabh’s medical practice as part of the scheme, Kaival also instructed Saurabh on which insurance companies covered the compound medications.
Following that, he requested that Saurabh prescribe those medications to existing patients of his practice who were covered by those insurance plans in order to benefit Kaival and his wife even more.
Kaival was charged with money laundering conspiracy, substantive money laundering counts, and making false statements to federal agents.
The maximum punishment for Saurabh is 10 years in prison and a $250,000 fine. On June 27, 2023, he will be sentenced.
