Canton resident convicted in health care fraud scheme

A Canton pharmacist and pharmacy owner, along with five other associates, were found guilty this month by a federal jury on 26 counts of an indictment charging him with conspiracy, health care fraud, and controlled substance distribution.

The jury deliberated a little more than three days before returning the verdict, concluding a six-week trial before United States District Judge Arthur J. Tarnow.

The jury convicted Babubhai (Bob) Patel, 49, four pharmacists he employed, Brijesh Rawal, 36, of Canton, Ashwini Sharma, 34, of Novi, Lokesh Tayal, 36, of Northville, and Viral Thaker, 31 of Findlay, Ohio, and one of Patel's business associates, Komal Acharya, 28, of Farmington Hills.

''These defendants stole money from the Medicare and Medicaid programs, which are designed to provide health care and medicine to some of our most vulnerable citizens,'' said United States Attorney Barbara L. McQuade. ''Pharmacists and health care providers should be aware that we are scrutinizing records to detect and prosecute health care fraud.''

''The diversion of prescription drugs coupled with the submission of fraudulent claims to Medicare creates a toxic scenario that can place an 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 diligently with our law enforcement partners to hold those who seek to harm the Medicare program accountable.''

The evidence presented at trial demonstrated that, from approximately January 2006 through August 2011, Babubhai Patel owned and controlled over 20 pharmacies, which were operated in and around Detroit.

In addition, the evidence showed that Patel's model for turning a profit at his pharmacies was based upon large-scale health care fraud and the diversion of controlled substances. Patel and his associates paid cash kickbacks and other forms of illegal remuneration to physicians in exchange for those physicians writing prescriptions for expensive medications, without regard to medical necessity, that could be billed to Medicare, Medicaid, or a private insurer through one of the Patel Pharmacies.

Physicians affiliated with Babubhai Patel would also write prescriptions for controlled substances for their patients, again regardless of medical necessity, which would then be filled at one of the Patel Pharmacies.

These controlled substances were distributed to patients and patient recruiters as a kickback in exchange for the patients using a Patel Pharmacy. ??Pharmacists within the Patel Pharmacies, including defendants Rawal, Tayal, Sharma, and Thaker, facilitated the fraud and controlled substance distribution schemes by billing Medicare, Medicaid, and private insurers for expensive, non-controlled medications which they had in inventory but never actually dispensed to the patients.

The surplus of medications generated through this practice was returned to wholesalers, thereby enabling the Patel organization to maximize its profit on its inventory of medications which were billed for but never dispensed.

The case was investigated by the Drug Enforcement Administration, the Department of Health and Human Services-Office of Inspector General, and the FBI. The case was prosecuted by Assistant United States Attorneys John K. Neal and Wayne F. Pratt.

Published: Thu, Aug 30, 2012