Indian-American medical biller arrested for stealing over $1 mn

New York, Jan 5: A 61-year-old Indian-origin medical biller has been arrested for allegedly stealing more than $1 million intended for surgeons who provided care to injured workers in New York.

Amrish Patel and his two companies -- Medlink Services and Medlink Partners -- were charged on Wednesday with 27 felony counts for the thefts they allegedly committed from January 2012 through January 2019.

Patel, who was arraigned before the Honorable Holly Trexler in Albany City Court, provided billing services to a Brooklyn-based orthopedic surgery practice, according to the Office of the New York State Attorney General.

He allegedly submitted falsified claim forms to the New York State Insurance Fund (NYSIF) to steal at least $1.1 million in workers’ compensation reimbursements for himself.

“Doctors and health care professionals provide crucial care to our communities, and they rely on accurate and ethical billing to sustain these services and ensure our wellbeing,” said New York Attorney General Letitia James.

“When money is illegally diverted away from doctors and providers, all New Yorkers suffer as a result. Fraud of any kind will never go unchecked in our state, and my office will continue to use every measure to hold accountable those who seek to cheat New Yorkers for personal gain."

As outlined in the 27-count complaint, Patel abused his position as a medical billing agent over the course of nearly seven years by diverting payments meant for surgeons.

Starting in 2011, Patel and his companies were responsible for submitting billing for surgeries related to work-related injuries under the New York State Workers’ Compensation Law.

Under the law, authorised providers are reimbursed for their treatment of injured workers by the insurance carrier for the employer.

Under the terms of their client agreement, Patel submitted bills for surgical procedures to NYSIF, the workers’ compensation carrier in this instance, and then the payments would subsequently be issued directly to the surgical practice or its doctors.

In exchange for these transactions, Patel and his companies were paid monthly service fees.

However, he allegedly submitted falsified claim forms to NYSIF and requested that the payments be sent to his companies instead of the doctors.

In total, Patel allegedly stole at least $1.1 million in payments originally intended for three doctors for services provided between January 1, 2012 and January 4, 2019.

The felony counts against him and his companies included, one count of Insurance Fraud in the First Degree; one count of Grand Larceny in the First Degree; one count of Grand Larceny in the Second Degree; one count of Grand Larceny in the Third Degree; one count of Scheme to Defraud in the First Degree; 11 counts of Falsifying Business Records in the First Degree, and 11 counts of Workers’ Compensation Fraud.

Patel was released with electronic monitoring and a $100,000 bond.