Feature

Telehealth doctor indicted on health care fraud, opioid distribution charges


 

A Michigan physician has been indicted by a federal grand jury on charges of health care fraud and conspiracy to distribute controlled substances.

Sangita Patel, MD, 50, practiced at Advance Medical Home Physicians in Troy.

According to court documents, between July 2020 and June 2022 Patel was responsible for submitting Medicare claims for improper telehealth visits she didn’t conduct herself.

Dr. Patel, who accepted patients who paid in cash as well as those with Medicare and Medicaid coverage, billed approximately $3.4 million to Medicare between 2018 and 2022, according to court documents. An unusual number of these visits were billed using complex codes, an indication of health care fraud. The investigation also found that on many days, Dr. Patel billed for more than 24 hours of services. During this period, according to the document, 76% of Dr. Patel’s Medicare reimbursements were for telehealth.

Prosecutors say that Dr. Patel prescribed Schedule II controlled substances to more than 90% of the patients in these telehealth visits. She delegated her prescription authority to an unlicensed medical assistant. Through undercover visits and cell site search warrant data, the investigation found that Dr. Patel directed patients to contact, via cell phone, this assistant, who then entered electronic prescriptions into the electronic medical records system. Dr. Patel then signed the prescriptions and sent them to the pharmacies without ever interacting with the patients. Prosecutors also used text messages, obtained by search warrant, between Dr. Patel and her assistant and between the assistant and undercover informers to build their case.

Dr. Patel is also accused of referring patients to other providers, who in turn billed Medicare for claims associated with those patients. Advance Medical received $143,000 from these providers, potentially in violation of anti-kickback laws, according to bank records obtained by subpoena.

If convicted, Dr. Patel could be sentenced to up to 10 years in federal prison.

A version of this article first appeared on Medscape.com.

Recommended Reading

20 years of clinical research in cardiology
MDedge Cardiology
NP-PA turf fights: Where the relationship can improve
MDedge Cardiology
EHR alerts boosted MRA prescribing to patients with HFrEF
MDedge Cardiology
NUDGE-FLU: Electronic ‘nudges’ boost flu shot uptake in seniors
MDedge Cardiology
Causal AI quantifies CV risk, providing patient-specific goals
MDedge Cardiology
Med center and top cardio surgeon must pay $8.5 million for fraud, concurrent surgeries
MDedge Cardiology
Keto/paleo diets ‘lower quality than others,’ and bad for planet
MDedge Cardiology
Specialty and age may contribute to suicidal thoughts among physicians
MDedge Cardiology
New documentary highlights human toll of high insulin cost
MDedge Cardiology
What’s it like to take Ozempic? A doctor’s own story
MDedge Cardiology