NEW YORK: A 44-year-old Indian-origin lab owner was sentenced o 27 years in prison for defrauding Medicare by submitting over $463 million in genetic and other laboratory tests that patients did not need.
According to court documents, Minal Patel’s Atlanta-based LabSolutions LLC was enrolled with Medicare and performed sophisticated genetic tests.
Patel conspired with patient brokers, telemedicine companies, and call centers to target Medicare beneficiaries with telemarketing calls. The calls falsely stated that Medicare covered expensive cancer genetic tests, a Department of Justice release said.
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.
To conceal the kickbacks and bribes, Patel required patient brokers to sign sham contracts that falsely stated that the brokers were performing legitimate advertising services for LabSolutions.
Patel knew that the brokers were deceptively marketing to Medicare beneficiaries and paying kickbacks and bribes to telemedicine companies for genetic testing prescriptions.
“In one of the largest genetic testing fraud cases ever tried to verdict, today’s sentence makes clear that the Department will seek justice for those who put profits above patient care, including owners and executives,” Acting Assistant Attorney General Nicole M, Argentieri of the Justice Department’s Criminal Division, said on Friday.
Patel knew the telemedicine doctors robo-signed prescriptions for expensive genetic testing even though they were not treating the beneficiaries, often did not even speak with them, and made no evaluation of medical necessity.
From July 2016 through August 2019, LabSolutions submitted more than $463 million in claims to Medicare, including for thousands of medically unnecessary genetic tests, of which Medicare paid over $187 million.
In that timeframe, Patel personally received over $21 million from Medicare in connection with the fraud.
“Patel bilked hundreds of millions of dollars from Medicare through a complex testing fraud scheme. He is now paying the price for this crime,” said Special Agent in Charge Jeffrey B. Veltri of the FBI Miami Field Office.
“Deception, kickbacks, and bribes have no place in the provision of legitimate genetic testing and telemedicine services to patients who need them,” Veltri said.
The case was brought as part of Operation Double Helix, a federal law enforcement action led by the Health Care Fraud Strike Force, focused on fraudulent genetic cancer testing.
The fraudulent testing has resulted in charges against dozens of defendants associated with telemedicine companies and cancer genetic testing laboratories for their alleged participation in one of the largest health care fraud schemes ever charged.