Indian American doctor accused of $448K Medicare fraud

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New York– An Indian-American doctor has been indicted for allegedly running a scheme to submit bogus claims to Medicare, and faces a 10-year felony charge.

Dr Sangita Patel, 50, allegedly submitted false and fraudulent claims for telehealth visits from the Advance Medical Home Physicians Center, located in Troy, according to a criminal complaint authored by the FBI.

From April 2020 till early February 2023, Patel allegedly submitted more than $1 million in false claims to Medicare for telehealth services she did not provide, the Michigan Live reported.

Medicare paid more than $448,000 on those fraudulent claims. Patel would delegate a person in Tuscola County to call Medicare beneficiaries on her behalf, according to cellular phone evidence. After these calls, Patel would submit claims as if she had provided telehealth visits to the Medicare beneficiaries whom the individual had called.

About 76 per cent of Patel’s Medicare reimbursements were for telehealth-related claims from about July 1, 2020, till June 30, 2022.

These payments were about nine times the payments for the prior two-year period, as per the complaint.

The complaint further said that Patel prescribed Schedule II controlled substances to more than 90 per cent of the patients involved in her telehealth insurance claims.

According to the Drug Enforcement Administration, Schedule II drugs have legitimate medical uses but are considered to have a high potential for abuse.

The Michigan Live reported that from 2019 through July 2022, Patel issued prescriptions for more than 590,000 tablets of prescription drugs. Of these, 70 per cent were for Schedule II drugs.

“These are serious allegations, and my office is committed to prosecuting any medical professional who attempts to exploit Medicare, a taxpayer-funded program that provides essential services to seniors and disabled individuals,” US Attorney Dawn N. Ison was quoted as saying in Michigan Live.

Patel’s fraud came to light after an informant reported that she was accepting cash in exchange for prescription drugs. The FBI and US Department of Health then began a probe on November 21.

“Physicians and other medical professionals who fraudulently bill our federal healthcare programs are stealing from taxpayers and robbing vulnerable patients of necessary medical care,” James A Tarasca, Special Agent in Charge of the FBI’s Detroit Field Office, told Michigan Live.

Currently, Patel is free on a $10,000 unsecured bond, and her next court hearing is due on March 1. (IANS)

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