CAMDEN, N.J. – A Newark doctor is facing a decade behind bars after admitting today to a sprawling health care fraud conspiracy that bilked state and local benefits programs, along with other insurers. Saurabh Patel, 51, of Woodbridge, New Jersey, pleaded guilty via video conference before U.S. District Judge Robert B. Kugler to one count of conspiring to commit health care fraud.
The scheme, according to federal investigators, revolved around medically unnecessary compounded medications – custom-mixed drugs often used when FDA-approved options aren’t suitable for a patient. Patel, operating his clinic in Newark, allegedly rubber-stamped prescriptions for these costly medications, regardless of actual patient need, in exchange for kickbacks. His co-conspirator, Kaival Patel, 52, of West New York, New Jersey, is also facing serious charges, including conspiracy to commit money laundering and making false statements to federal agents. Kaival Patel maintains his innocence and is scheduled for trial later this year.
Court documents reveal that Kaival Patel and a pharmaceutical sales rep, Paul Camarda, established ABC Healthy Living LLC to aggressively market these compound medications. Camarda previously pleaded guilty to health care conspiracy, money laundering conspiracy, and obstruction of justice and is awaiting sentencing. The trio identified individuals with insurance plans that generously reimbursed for these specific medications, then steered them to Patel’s clinic for authorization. Essentially, Patel was paid to sign off on prescriptions for people who didn’t need them, lining the pockets of Kaival Patel and his operation.
The fraud didn’t stop there. Kaival Patel allegedly instructed Saurabh Patel on which insurance companies were most lucrative for these prescriptions and even directed him to prescribe the medications to existing patients with those specific insurance plans. This brazen manipulation maximized payouts and fueled the conspiracy. The clinic visits and procedures associated with these fraudulent prescriptions also generated additional insurance payments for Patel, adding to the illicit gains.
Saurabh Patel now faces a maximum penalty of 10 years in prison and a $250,000 fine. Sentencing is scheduled for June 27, 2023. The case was spearheaded by Attorney for the United States Vikas Khanna, with significant contributions from agents of the IRS Office of Criminal Investigation, the FBI’s Atlantic City Resident Agency, and the U.S. Department of Labor Office of Inspector General.
This case serves as a stark reminder of the vulnerabilities within the healthcare system and the lengths to which individuals will go to exploit it for personal profit. Senior Trial Counsel Christina O. Hud and Chief R. David Walk Jr. of the Health Care Fraud Unit are leading the prosecution, signaling a continued crackdown on such schemes in New Jersey and beyond. The Grimy Times will continue to follow this case and report on any further developments.
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Key Facts
- State: New Jersey
- Agency: DOJ USAO
- Category: Fraud & Financial Crimes
- Source: Official Source ↗
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