A federal jury in the Southern District of Florida has convicted a Georgia man for his role in a scheme to defraud Medicare by submitting more than $463 million in claims for genetic and other laboratory tests, the U.S. Department of Justice (DOJ) said Wednesday.
Not only were the tests not needed, but they were also procured through the payment of kickbacks.
According to court documents and evidence presented at trial, Minal Patel of Atlanta owned LabSolutions, which performed the genetic tests.
Patel conspired with patient brokers, telemedicine companies, and call centers to target Medicare beneficiaries with telemarketing calls. In the calls, the lab owner falsely stated that Medicare covered expensive cancer genetic tests, the DOJ said.
After the Medicare beneficiaries agreed to take a test, Patel paid kickbacks and bribes to the patient brokers to obtain signed doctors’ orders authorizing the tests from telemedicine companies. To conceal the kickbacks, Patel required patient brokers to sign contracts that falsely stated that they were performing legitimate advertising services for LabSolutions, DOJ said.
The telemedicine doctors approved the expensive testing even though they were not treating the beneficiaries and often did not speak to them.
From July 2016 through August 2019, LabSolutions submitted more than $463 million in claims to Medicare, including for the medically unnecessary genetic tests. Medicare paid more than $187 million, and Patel personally received more than $21 million.
Patel was convicted of one count of conspiracy to commit healthcare fraud and wire fraud, three counts of healthcare fraud, one count of conspiracy to defraud the U.S. and to pay and receive illegal healthcare kickbacks, four counts of paying illegal healthcare kickbacks, and one count of conspiracy to commit money laundering.
He is scheduled to be sentenced on March 7, 2023.
The Federal Bureau of Investigation (FBI) and Department of Health and Human Services, Office of Inspector General (HHS-OIG) investigated the case.