|August 2nd, 2011, 02:18 PM||#1|
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Twenty Six Indicted in Massive Michigan Health Care Fraud
U.S. Attorney's Office - Twelve Pharmacists, four doctors, an accountant, and a psychologist among those charged in scheme alleging criminal activity at over 20 pharmacies statewide.
An indictment returned by a federal grand jury in Detroit was unsealed today, charging twenty-six individuals for their participation in a large-scale health care fraud and drug distribution scheme, United States Attorney Barbara L. McQuade announced today. McQuade was joined in her announcement by Special Agent in Charge Robert L. Corso of the Drug Enforcement Administration, Special Agent in Charge Andrew G. Arena of the Federal Bureau of Investigation, and Lamont Pugh, Special Agent in Charge of the Inspector General of the Department of Health and Human Services.
"Health care fraud steals funds from programs designed to benefit patients, and we all pay for it," U.S. Attorney McQuade said. "Federal and state investigators have teamed up in recent months to detect and prosecute those who commit health care fraud, and we hope that the strength of our efforts will have a deterrent effect."
Robert L. Corso, Special Agent in Charge of DEA's Detroit Field Division stated, "Confronting the illegal diversion and abuse of controlled pharmaceuticals is a top priority of DEA and our law enforcement partners. Today's arrests and the allegations in the indictment bring to light one of the largest diversion conspiracies ever uncovered in the state of Michigan.
The allegations against these 26 individuals, particularly of the medical professionals, are significant. These individuals abused their positions of trust and endangered the lives of countless people by illegally distributing more than 6 million doses of opiate painkillers and depressants throughout southeast Michigan and beyond.
This indictment makes it clear that the DEA and our partners in law enforcement will continue to investigate and bring to justice those individuals that are responsible for the illegal distribution of prescription medicines."
FBI Special Agent in Charge Arena stated, “Health care fraud and the abuse/diversion of prescription medications are increasing criminal threats to the United States. Dishonest health care providers involved in fraudulent activities frequently exploit Medicare and Medicaid through fraudulent billing schemes which abuse tax payer's dollars. The FBI remains committed to investigating this type of fraud and bringing these individuals to justice.”
"The diversion of prescription medications coupled with the fraudulent billing of Medicare creates a toxic scenario that can place a individual's health and safety at risk as well as taxpayers dollars" said Lamont Pugh III, Special Agent in Charge of the Chicago Region for the U.S. Department of Health and Human Services, Office of Inspector General. "The OIG will continue to work with our law enforcement partners to hold those who seek to harm the Medicare program accountable.
The 34-count indictment alleges that Babubhai "Bob" Patel, 49, a Canton pharmacist, was the beneficial owner and controller of some 26 pharmacies statewide (referred to in the indictment as "the Patel Pharmacies").
Babubhai Patel concealed his ownership and control over many of the Patel Pharmacies through the use of straw owners. The indictment alleges that Babubhai Patel would offer and pay kickbacks, bribes, and other inducements to physicians, in order to induce those physicians to write prescriptions for patients with Medicare, Medicaid, and private insurance, and to direct that those prescriptions be presented to one of the Patel Pharmacies for billing.
In exchange for their kickbacks and inducements, the medical professionals would write prescriptions for the patients, and bill the relevant insurers for services supposedly provided to the patients, without regard to the medical necessity of those prescriptions and services.
The physicians would direct the patients to fill their prescriptions at one of the Patel Pharmacies. There, according to the indictment, Babubhai Patel and his pharmacists would bill insurers, including Medicare, Medicaid, and private insurers, for dispensing the medications, despite the fact that the medications were medically unnecessary and/or never provided. Patients were recruited into the scheme by patient recruiters, who would pay kickbacks and bribes to patients in exchange for the patients' permitting the Patel Pharmacies (and the physicians associated with Patel) to bill their insurance for medications and services that were medically unnecessary and/or never provided.
The indictment further alleges a conspiracy to distribute controlled substances at the Patel pharmacies, a purpose of which was to facilitate the submission of false and fraudulent claims to Medicare, Medicaid, and private insurers in accordance with the scheme outlined above.
According to the indictment, Babubhai Patel and his associates paid physicians and podiatrists associated with the scheme kickbacks
Last edited by Steve-in-Petoskey; August 2nd, 2011 at 02:21 PM.
|August 2nd, 2011, 02:59 PM||#4|
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