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Indian-American doctor admits healthcare fraud conspiracy

New York, Feb 20 (IANS) An Indian-American doctor has admitted defrauding New Jersey state and local health benefit programmes and other insurers by submitting fraudulent claims for medically unnecessary prescriptions.

Saurabh Patel, 51, who owns a medical clinic in Newark, pleaded guilty by videoconference before the US District Judge Robert B. Kugler last week to a superseding information charging him with one count of conspiring to commit healthcare fraud.

Saurabh of Woodbridge, New Jersey, was previously charged by indictment with conspiring in the healthcare fraud scheme with a family member, Kaival Patel.

According to court documents, despite having no background in pharmaceuticals or medicine, Kaival and his wife created and operated a company called ABC Healthy Living LLC to market medical products and services, including compound prescription medications.

Kaival and an accomplice then approached Saurabh and convinced him to authorise prescriptions for the compound medications for which they received commissions, regardless of whether or not those prescriptions were medically necessary.

The conspirators steered individuals who were paid to receive the compound medications to Saurabh’s medical practice for the purpose of receiving his authorisation on the fraudulent prescriptions, a Department of Justice said in a statement.

This enabled Saurabh to receive insurance payments for those patient visits and procedures. In addition to the people steered to Saurabh’s medical practice as part of the scheme, Kaival also instructed Saurabh on which insurance companies covered the compound medications.

Thereafter, he requested that Saurabh prescribe those medications to existing patients of his practice with those insurance plans in order to further benefit Kaival and his wife.

Kaival was charged with conspiracy to commit money laundering, substantive counts of money laundering, and making false statements to federal agents.

He is scheduled to proceed to trial later this year.

Saurabh faces a maximum penalty of 10 years in prison and a $250,000 fine. His sentencing is scheduled for June 27, 2023.