A Southern District of Florida jury convicted a Georgia man for a $463 million scheme to defraud Medicare by submitting unnecessary tests conducted by his lab. According to the Department of Justice, the defendant arranged unnecessary genetic tests using kickbacks to conspirators. The Federal Bureau of Investigation and Department of Health and Human Services, Office of Inspector General handled the investigation as part of Operation Double Helix, which focuses on fraudulent genetic cancer testing.
How the scam worked
The defendant, Minal Patel, who owned the Atlanta-based LabSolutions, colluded with patient brokers and telemedicine companies and call centers to target Medicare beneficiaries with telemarketing solicitations. During the calls, the telemarketers claimed that Medicare covered the expensive cancer genetic tests, which was false.
Patel paid bribes and kickbacks to patient brokers who secured patient tests and obtained signed doctor authorization for the test from telemedicine companies. To conceal the kickbacks, Patel required that the patient brokers sign contracts that they were performing legitimate services for LabSolutions, which was also false. The doctors authorizing the tests rarely spoke with patients and did not personally treat the patients.
The $463 million scam went from July 2016 to August 2019. Medicare paid upwards of $187 million in claims for the tests, and Patel personally received $21 million.
Patel faces criminal charges
The DOJ convicted Patel of conspiracy to commit healthcare fraud, three counts of healthcare fraud, conspiracy to defraud the U.S., four counts of paying and receiving healthcare kickbacks, and conspiracy to commit money laundering. He faces the potential of 20 years for the first count and ten more years for each additional count. The sentencing is scheduled for March 7.