Florida pharmacy owner to pay $865k after healthcare fraud conviction

Following a U.S. Department of Labor investigation, the U.S. District Court for the Western District of Kentucky has sentenced Nitesh Patel to serve 12 months' probation, including 12 months of home confinement following his Nov. 3, 2021, guilty plea to one count of conspiracy to commit healthcare fraud.

The court also ordered Patel to pay $865,240 in restitution, a $10,000 fine and ordered Patel to forfeit $100,000. Patel paid the $865,240 in restitution and $100,000 in forfeiture monies at sentencing.

EBSA's investigation found that - between November 2014 and June 2018 - Patel engaged in the healthcare fraud with a Louisville, Kentucky physician. Patel falsely billed private insurance companies and healthcare benefit programs - including Tricare, a healthcare program for military members, retirees and their families - with inflated prices on prescriptions.

Patel's actions led the healthcare benefit programs to pay higher reimbursement rates to him and his Clearwater-based pharmacy.

"Healthcare fraud abuses the public trust. These illegal activities hurt participants who depend on their benefits, and employers who provide healthcare coverage and companies providing the insurance," said Employee Benefits Security Administration Regional Director Joe Rivers in Cincinnati. "These schemes also raise the cost Americans pay for health insurance. The U.S. Department of Labor will hold those who defraud plans, participants, and beneficiaries accountable."