Indian-American convicted in $463 mn healthcare fraud

New York, Dec 15 (IANS) An Indian-American lab owner has been convicted for his role in a scheme to defraud Medicare by submitting over $463 million in genetic and other laboratory tests that patients did not need.

According to court documents and evidence presented at the trial on Wednesday, Atlanta-based Minal Patel, 44, owned LabSolutions LLC -- a lab enrolled with Medicare that performed sophisticated genetic tests. From July 2016 to August 2019, LabSolutions submitted more than $463 million in claims to Medicare, including for medically unnecessary genetic tests, of which Medicare paid over $187 million, according to the US Department of Justice.

In that timeframe, Patel personally received over $21 million in Medicare proceeds.

He conspired with patient brokers, telemedicine companies, and call centres to target Medicare beneficiaries with telemarketing calls falsely stating that Medicare covered expensive cancer genetic tests.

After the Medicare beneficiaries agreed to take a test, Patel paid kickbacks and bribes to patient brokers to obtain signed doctors' orders authorising the tests from telemedicine companies, a Department of Justice statement noted.

To conceal the kickbacks, Patel required patient brokers to sign contracts that falsely stated that they were performing legitimate advertising services for LabSolutions.

The telemedicine doctors approved the expensive testing even though they were not treating the beneficiaries and often did not even speak with them, the statement said.

The federal jury in the Southern District of Florida convicted Patel of one count of conspiracy to commit healthcare fraud and wire fraud, three counts of healthcare fraud, one count of conspiracy to defraud the US and to pay and receive illegal health care kickbacks.

He was also convicted of four counts of paying illegal health care kickbacks, and one count of conspiracy to commit money laundering.

Patel is scheduled to be sentenced on March 7, next year, and faces a maximum penalty of 20 years in prison on the first conspiracy count, 10 years on each health care fraud count, five years on the second conspiracy count, 10 years on each kickback count, and 20 years on the third conspiracy count.