Jay Clayton, the United States Attorney for the Southern District of New York, has announced that Manishkumar Patel was sentenced to 14 months in prison by U.S. District Judge Lorna G. Schofield. Patel had previously pled guilty to conspiring to commit healthcare fraud, wire fraud, and violating the Anti-Kickback Statute.
U.S. Attorney Jay Clayton stated: “As he previously admitted, Manishkumar Patel bilked Medicare for nearly $50 million. Frauds on our Medicare system increase costs for all Americans, and worse yet, potentially restrict access to those in need of critical healthcare. Patel’s 14 month sentence in federal prison sends an important deterrent message to those who would seek to bilk our Medicare system.”
Court documents reveal that between 2019 and 2022, Patel and a co-conspirator engaged in fraudulent activities involving prescriptions and doctors’ orders for durable medical equipment, pharmaceuticals, and laboratory tests sold to suppliers and laboratories termed as "Medicare Providers."
Patel acquired these scripts through call centers that reached out to Medicare beneficiaries with basic questions intended to justify a reimbursable script by Medicare. These were then turned into scripts through telemedicine appointments or doctor chasing—a process where doctors signed scripts without patient interaction—and even through forged scripts. The resulting scripts were sold to providers who billed Medicare despite many beneficiaries rejecting the items sent.
The payments made by Medicare Providers for these scripts violated the Anti-Kickback Statute as they involved sham contracts disguised as generic marketing services at flat rates.
Patel's leadership in this scheme led to approximately $48 million in losses for Medicare.
In addition to his prison term, Patel will serve one year of home detention and is ordered to pay restitution amounting to $48,150,692.49 along with forfeiting $6,839,900.
Jay Clayton commended the efforts of the U.S. Department of Health and Human Services' Office of Inspector General in this case prosecuted by the Complex Frauds and Cybercrime Unit with Assistant U.S. Attorney Kevin Mead leading the prosecution.