In a landmark case, Minal Patel, the owner of LabSolutions LLC, was sentenced to 27 years in prison for orchestrating a $463 million genetic testing scheme that defrauded Medicare. Alongside patient brokers, telemedicine companies, and call centers, Patel targeted Medicare beneficiaries through telemarketing calls, falsely claiming that Medicare covered expensive cancer genetic tests. Patel paid kickbacks and bribes to patient brokers to obtain signed doctors’ orders for the tests, while concealing the illegal activities through sham contracts. The scheme resulted in over $187 million in fraudulent payments from Medicare, with Patel personally receiving over $21 million. This sentence demonstrates the U.S. Department of Justice’s commitment to fighting fraud in telemedicine and genetic testing that exploits patients and drains healthcare benefit programs.
Lab Owner Sentenced for $463M Genetic Testing Scheme
In a significant case of healthcare fraud, a lab owner from Georgia has been sentenced to 27 years in prison for his involvement in a scheme that defrauded Medicare of over $463 million. The defendant, Minal Patel, owned LabSolutions LLC, a laboratory enrolled with Medicare that performed genetic tests. This scheme involved fraudulent practices and collaboration with various individuals and organizations. The sentencing serves as a strong message from the justice system regarding its commitment to fighting fraud in the healthcare industry.
Patel played a central role in the fraudulent scheme. He conspired with patient brokers, telemedicine companies, and call centers to target Medicare beneficiaries through telemarketing calls. These calls falsely claimed that Medicare covered expensive cancer genetic tests. Once patients agreed to take the tests, Patel paid kickbacks and bribes to patient brokers to obtain signed doctors’ orders, authorizing the unnecessary tests. To conceal these illicit transactions, Patel required patient brokers to sign sham contracts that falsely claimed they were providing legitimate advertising services for LabSolutions.
The fraudulent practices employed by Patel and his collaborators involved deceiving Medicare beneficiaries through telemarketing calls and exploiting their trust. The scheme relied on making false claims about the coverage of expensive genetic tests and manipulating patients into agreeing to unnecessary procedures. Patel also engaged in illegal activities by paying kickbacks and bribes to patient brokers and telemedicine companies for genetic testing prescriptions. These practices not only defrauded Medicare but also compromised patient care and drained healthcare benefit programs.
Patel’s scheme involved collaboration with various individuals and organizations. Patient brokers played a crucial role by connecting Medicare beneficiaries with LabSolutions and procuring signed doctors’ orders. Telemedicine companies and call centers facilitated the telemarketing calls to target potential patients. The collaboration between these parties demonstrates a sophisticated and coordinated effort to defraud Medicare through genetic testing.
Justice Department’s Response
This verdict highlights the importance of holding individuals accountable for their involvement in fraudulent practices that put profits above patient care. The Acting Assistant Attorney General of the Justice Department’s Criminal Division, Nicole M. Argentieri, emphasized the department’s ongoing commitment to combat telemedicine and genetic testing fraud, which exploits patients and drains healthcare benefit programs. The sentencing serves as a warning to others involved in similar fraudulent activities that they will face justice.
Ongoing Commitment to Fighting Fraud
The Justice Department remains dedicated to fighting fraud in the healthcare industry. The collaboration between law enforcement agencies such as the FBI and the HHS-OIG plays a crucial role in exposing fraudulent schemes and bringing the responsible individuals to justice. This commitment extends to prosecuting healthcare fraud cases involving telemedicine, genetic testing, and other areas of healthcare where fraud is prevalent.
Amount of Fraudulent Claims
The total amount of fraudulent claims submitted by LabSolutions during the scheme was over $463 million. These claims included thousands of medically unnecessary genetic tests. Medicare paid out over $187 million for these tests, contributing to the financial impact of the scheme. The substantial sums involved highlight the magnitude of the fraud and the need for swift and decisive action by law enforcement.
Medicare Payments Received
During the scheme’s duration, Patel personally received over $21 million from Medicare in connection with the fraudulent activities. These substantial payments demonstrate the financial incentive behind the scheme and the individual’s profit-driven motives. The investigation and subsequent sentencing not only hold Patel accountable for his actions but also ensure that ill-gotten gains are confiscated through asset forfeiture proceedings.
The investigation into Patel’s scheme was a collaborative effort between the FBI and the HHS-OIG. The close partnership and diligence of these law enforcement agencies were vital in uncovering the fraudulent practices and gathering the evidence necessary to prosecute the case. The joint efforts of the FBI and the HHS-OIG showcase the government’s commitment to investigating and dismantling healthcare fraud schemes that defraud Medicare and exploit patients.
Trial Attorneys and Prosecution
The prosecution of Patel’s case was conducted by dedicated trial attorneys from the Criminal Division’s Fraud Section. Trial Attorneys Jamie de Boer, Emily Gurskis, Reginald Cuyler Jr., Katherine Rookard, and Patrick Queenan worked tirelessly to present the evidence and build a strong case against the defendant. Their efforts demonstrate the expertise and commitment of the Department of Justice in prosecuting complex healthcare fraud cases.
Asset Forfeiture Proceedings
Following the sentencing, asset forfeiture proceedings are now underway. These proceedings aim to confiscate assets obtained through illegal activities, such as the fraudulent scheme orchestrated by Patel. Assistant U.S. Attorney Marx Calderon is handling the asset forfeiture proceedings in the Southern District of Florida. An upcoming hearing is scheduled to address the forfeiture of ill-gotten gains on August 25.
Operation Double Helix
This healthcare fraud case is part of Operation Double Helix, a federal law enforcement action led by the Health Care Fraud Strike Force. Operation Double Helix focuses on combating fraudulent genetic cancer testing, which has become one of the largest healthcare fraud schemes to date. The Strike Force’s efforts have resulted in charges against multiple defendants associated with telemedicine companies and cancer genetic testing laboratories. These coordinated law enforcement actions demonstrate the government’s determination to root out healthcare fraud and protect both patients and healthcare benefit programs.
Focus on Fraudulent Genetic Testing
The case against Patel and the ongoing Operation Double Helix highlight the specific focus on combating fraudulent genetic testing schemes. Genetic testing is an area of healthcare that has seen a rise in fraud due to its potential for high billing. The Justice Department, together with other law enforcement agencies, is committed to investigating and prosecuting cases involving fraudulent genetic testing to safeguard the integrity of healthcare programs and protect patients.
Other Health Care Fraud Cases
Patel’s case is not an isolated incident. The Department of Justice has prosecuted and convicted individuals involved in various healthcare fraud schemes. These cases highlight the diverse strategies employed by fraudsters to exploit healthcare benefit programs and defraud patients. Recent convictions include individuals submitting false statements to COVID-19 relief programs, doctors engaging in COVID-19 healthcare fraud schemes, and pharmacy owners participating in the payment of illegal kickbacks. These convictions demonstrate the Justice Department’s unwavering commitment to pursuing and punishing healthcare fraud in all its forms.
In conclusion, the sentencing of the lab owner involved in the $463 million genetic testing scheme sends a strong message that healthcare fraud will not be tolerated. The justice system is committed to holding individuals accountable and protecting patients and healthcare benefit programs. The collaboration between law enforcement agencies, such as the FBI and the HHS-OIG, is instrumental in uncovering and prosecuting these complex fraud schemes. Through ongoing operations and prosecutions, the Justice Department aims to dismantle fraudulent schemes and safeguard the integrity of healthcare programs.