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$50M Scheme: Pelham Manor Man Charged By Feds

A 44-year-old Westchester man has admitted to a healthcare fraud scheme that cost Medicare nearly $50 million in losses, federal officials announced.

Prescription drugs.

Prescription drugs.

Photo Credit: Pixabay/Charles Thompson

Pelham Manor resident Manishkumar Patel pleaded guilty on Friday, April 26 to charges connected to a healthcare fraud and kickback scheme involving the sale of fraudulent prescriptions, according to the US Attorney's Office for the Southern District of New York.

According to federal officials, between 2019 and 2022, Patel and a co-conspirator would fraudulently sell prescriptions and doctors' orders for durable medical equipment, pharmaceuticals, and laboratory tests to Medicare providers. 

Patel would obtain these fraudulent prescriptions and doctor's orders from call centers that would contact Medicare beneficiaries and ask them questions designed to justify their reimbursements from Medicare. 

He would then take part in a practice called "doctor chasing" and send the information from these calls to a doctor who would sign off on the orders without seeing patients. These doctors often did not know what they were signing, officials said.

These signed "scripts" for prescriptions and medical equipment would then be sold by Patel to Medicare providers, who would fill the orders and bill Medicare. 

Because the orders were fraudulently obtained, many beneficiaries later rejected the items they were sent by providers. Additionally, many doctors threatened to report Patel for fraud, and Medicare often refused to pay for the false orders, according to officials.

As a result of the scheme, Medicare lost nearly $50 million, officials said.

On Friday, Patel pleaded guilty to:

  • Conspiracy to commit healthcare fraud; 
  • Wire fraud;
  • Violating the Anti-Kickback Statute.

Each of these counts carries a maximum sentence of five years in prison.

Furthermore, Patel was also ordered to pay $48,150,692.49 to the US Centers for Medicare and Medicaid Services and forfeit $6,839,900. 

US Attorney Damian Williams condemned Patel's fraudulent actions: 

"Behind every dollar siphoned through fraud lies a patient denied rightful care," he said, adding, "Manishkumar Patel cost Medicare nearly $50 million in resources that could have been used to provide genuine care to those in need. His guilty plea today is a step toward restoring integrity and trust in our health care system.” 

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