Westchester Mastermind Behind $50M 'Doctor Chasing' Fraud Admits Guilt

PELHAM, NY — The leader at the center of a $50 million federal health care fraud case admitted his role in the complicated scheme to defraud Medicare.

Damian Williams, the United States Attorney for the Southern District of New York, announced that Manishkumar Patel pleaded guilty today in connection with the $50 million health care fraud and kickback plot involving the sale of fraudulent prescriptions for durable medical equipment, among other medical supplies, to suppliers, pharmacies, and laboratories, who then obtained payment for those fraudulent prescriptions from Medicare.

"Behind every dollar siphoned through fraud lies a patient denied rightful care," Williams said."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."

Between 2019 and 2022, Patel and an accused co-conspirator fraudulently sold the prescriptions and doctors’ orders for durable medical equipment, pharmaceuticals, and laboratory tests to durable medical equipment suppliers, pharmacies, and laboratories.

Patel obtained the scripts from call centers that called Medicare beneficiaries and asked them perfunctory questions designed to justify a script that would be reimbursed by Medicare. He then turned the information from those calls into scripts by arranging cursory telemedicine appointments with the beneficiaries — a practice referred to as "doctor chasing," in which the information was sent to a doctor who signed the script without seeing the patient and who was frequently unaware of what they were signing — and obtaining forged scripts.

Patel then sold the scripts to Medicare providers, which filled the orders and billed Medicare.

Because the scripts were fraudulently obtained, the scheme soon started to unravel. Many beneficiaries rejected the items they were sent by the Medicare providers, doctors threatened to report Patel for fraud, and Medicare frequently refused to pay for the scripts.

The Medicare providers made payments to Patel for the scripts in violation of the Anti-Kickback Statue. Patel and those Medicare providers entered into sham contracts for generic marketing services at flat rates in an attempt to conceal their illegal kickback scheme.

Prosecutors said Patel was a leader of the scheme, which resulted in losses to Medicare of nearly $50 million.

The 44-year-old Pelham Manor man pleaded guilty to one count of conspiracy to commit health care fraud, one count of wire fraud, and one count of violating the federal "anti-kickback statute," each of which carries a maximum sentence of five years in prison.

Patel was also ordered to pay $48,150,692.49 in restitution to the U.S. Centers for Medicare and Medicaid Services and forfeit $6,839,900.