This week’s Scoundrel in the Spotlight is Minal Patel who last week (August 18) was sentenced to 27 years in prison for defrauding Medicare of almost half a billion dollars for genetic testing patients did not need and were procured through bribes and kickbacks.  In announcing the sentencing, the government trumpeted the matter as one of the largest genetic testing fraud cases ever tried to verdict.

Here is how the government described Patel’s scheme.  Through his genetics testing company LabSolutions LLC, Patel conspired with patient brokers, telemedicine companies, and call centers to sign up Medicare patients for expensive cancer genetic tests.  He then secured doctors’ orders for the tests through kickbacks and bribes to patient brokers and telemedicine companies.  Patel concealed these illicit payments through sham contracts with the patient brokers purporting to cover advertising services for LabSolutions.

According to the government, the testing had nothing to do with medical need.  It was just about the money.  Patel knew the telemedicine doctors robo-signed prescriptions for expensive genetic testing even though they were not treating the patients, often did not even speak with them, and made no evaluation of medical necessity.  In just the three-year period of July 2016 through August 2019, LabSolutions submitted more than $463 million in Medicare claims covering thousands of medically unnecessary genetic tests.  Patel’s personal take apparently was over $21 million.

The amount of jail time Patel was sentenced to is a testament to how seriously the government takes these Medicare fraud schemes and its commitment to go after individual health care providers and executives who put profits above patient care.  Especially when bribes and kickbacks are involved.  Lately, the government has tried to be especially vigilant of telemedicine companies and whether the care they provide is medically necessary.  As FBI Agent Jeffrey B. Veltri put it:

Deception, kickbacks, and bribes have no place in the provision of legitimate genetic testing and telemedicine services to patients who need them.  Patel bilked hundreds of millions of dollars from Medicare through a complex testing fraud scheme.  He is now paying the price for this crime. . . .  Our message to those who commit Medicare fraud and steal from U.S. taxpayers is clear: you will be caught and you will be held accountable.

It is for exploiting thousands of elderly patients and burdening them with medical testing they did not need that Mr. Patel has earned this week’s focus for our Scoundrel in the Spotlight.

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Anti-Kickback Statute and Stark Law
Healthcare Fraud
Medically Unnecessary Services
I Think I Have a Whistleblower Case
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Read Scoundrel Spotlight – Medicare Fraudster Minal Patel at constantinecannon.com