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IT AIN’T OVER UNTIL THE DOCTOR SINGS
They got the pharmacist, “Bob” Patel, RPh, and handed down a Federal District Court sentence of 17 years behind bars. The net is getting larger, though, with the recent federal indictment of five more physicians and four more pharmacists in the case.
At the center of the case is an estimated $20 million in fraudulent prescription claims to Medicare, Medicaid, and private insurers over a span of five years Millions of opioid painkillers were dispensed through Patel’s 26 pharmacies, It was a game of names; if there was an insurance carrier to pay the bill, pay they did. The patients, recruited by “marketers,” were rewarded with pills and those physicians prescribing them were rewarded with bribes from Patel. Some of the physicians also were rewarded for referring patients to home health agencies under Patel’s control. In turn, these agencies billed Medicare for services that were medically unnecessary and/or not provided.
At the same time that Patel was indicted, August 2011, so were four physicians, one psychologist, a dozen pharmacists and nine others. All were indicted for fraud and drugrelated charges. Patel and five of the other defendants were convicted in a jury trial during 2012 and 15 more have since pled guilty. Two of those guilty pleas came from Paul Petre, MD (conspiring to commit healthcare fraud and conspiracy to distribute controlled substances), who is facing a possible sentence of up to 8.5 years, and Mustak Vaid, MD (conspiring to commit healthcare fraud), who is looking at six months of confinement.
Trial material revealed that Patel aimed for a 25% profit margin in his pharmacies by billing insurers for prescribed noncontrolled drugs that were never dispensed and shorting prescriptions by two or three pills each. Unused drugs were either returned to wholesalers or sold on the black market