Medicare patients took unnecessary genetic cancer tests in man’s $463M scheme, feds say

A Georgia man persuaded Medicare patients to take medically unnecessary genetic tests, then billed nearly half a million dollars to the insurance program, prosecutors say.

Minal Patel was sentenced to 27 years in prison on Aug. 18 in connection with the scheme that involved his company submitting $463 million in claims to Medicare for cancer genetic tests that were “procured through the payment of kickbacks and bribes,” according to a news release from the Department of Justice.

Patel, 44, owned LabSolutions in Atlanta. Officials say he worked with other entities to target people on Medicare with telemarketing calls and falsely told them they could take expensive cancer genetic tests that were covered by Medicare.

“After the Medicare beneficiaries agreed to take a test, Patel paid kickbacks and bribes to patient brokers to obtain signed doctors’ orders authorizing the tests from telemedicine companies,” the release said.

Patel knew the telemedicine companies robo-signed prescriptions ordering the genetic tests without evaluating the patients, prosecutors say.

Cancer genetic testing looks at patients’ genes to see if they carry certain mutations linked with cancer, according to the American Cancer Society. The scheme targeted Medicare beneficiaries, which include people over 65 and people with disabilities.

Patel’s counsel, Tama Kudman and Kevin Raphael, told McClatchy News “the sentencing was notable” because the court “declined to utilize ‘intended loss’ in calculating Mr. Patel’s base offense level under the Guidelines.”

In the Third Circuit case U.S. v. Frederick H. Banks, which the lawyers said Patel’s case “adopted the reasoning of,” the court ruled that Banks did not actually cause loss to the financial institution that prosecutors say he defrauded, only that he intended to.

Lawyers for Patel said “the judge discussed the scope of the conspiracy in terms of intended loss.”

LabSolutions submitted $463 million in claims to Medicare from July 2016 to August 2019, prosecutors say. In the end, the insurance program paid $187 million in claims.

Patel got more than $21 million, according to the release.

“Deception, kickbacks and bribes have no place in the provision of legitimate genetic testing and telemedicine services to patients who need them,” said Special Agent in Charge Jeffrey Veltri of the FBI Miami Field Office. “Patel bilked hundreds of millions of dollars from Medicare through a complex testing fraud scheme.”

The case against LabSolutions, which has since shut down, was prosecuted in the Southern District of Florida, according to court records.

A Ferrari and a Range Rover were among the assets the government seized from Patel, according to a 2019 announcement from the DOJ.

Patel was among 35 people charged across the country who investigators say were involved in billing billions of dollars in fraudulent genetic testing to Medicare, the release said.

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