iNDICA NEWS BUREAU-
New York Attorney General Letitia James and New York State Inspector General Lucy Lang on December 9 announced the conviction and sentencing of Indian American medical biller Amrish Patel, 62, for stealing more than $1.1 million that was intended to be paid directly to doctors who provided medical care to injured workers under the New York State Workers’ Compensation Law.
Patel, a resident of Monroe Township in New Jersey, provided billing services to a Brooklyn-based orthopedic surgery practice, stole at least $1.1 million in workers’ compensation reimbursements from three surgeons by submitting falsified claim forms to the New York State Insurance Fund (NYSIF).
As per official records, Patel used these stolen funds to pay for luxury vehicles and vacations. He had previously pleaded guilty to one count of Insurance Fraud in the Second Degree, a Class C felony, and was sentenced to five years of probation and ordered to pay $300,000 in restitution to the victim doctors on December 9.
Talking about Patel, Attorney General James said stealing funds meant to provide care for injured workers harms medical professionals and puts a crucial lifeline for New Yorkers at risk.
“Instead of performing the billing services he was hired to do, Amrish Patel pocketed more than a million dollars intended for doctors who provided essential care, and then spent the money on luxury vehicles and expensive vacations. I thank our partners for their collaboration in this investigation, and we will continue to go after all those who attempt to cheat our health care system for personal gain,” the Attorney General said.
Inspector General Lucy Lang said: “Through an elaborate fraud, the defendant’s actions undermined the trust that New Yorkers place in our workers’ compensation system. By falsifying records and diverting funds, he exploited vulnerable workers and deprived medical professionals of rightful payments.”
“Today’s sentencing sends a clear message that those who seek to defraud our systems will face severe consequences. I commend the collaborative efforts of the Attorney General’s office, NYSIF, and my office in bringing this matter to justice,” the Inspector General added.
New York State Insurance Fund Executive Director and CEO Gaurav Vasisht said: “NYSIF is deeply committed to rooting out workers’ compensation fraud. These felonies raise the cost of doing business and dip into the pockets of every honest citizen and employer in New York State. Thank you to the Attorney General and Inspector General for their commitment to this investigation.”
A joint investigation by the Office of the Attorney General’s (OAG) Criminal Enforcement and Financial Crimes Bureau (CEFC), the Offices of the Inspector General’s (OIG) Workers’ Compensation Fraud unit (WCFIG), and NYSIF was conducted into the case.
It found that from January 2012 through January 2019, Patel abused his position as a medical billing agent by stealing payments that were intended for surgeons who provided care to those claiming workers’ compensation benefits. He was responsible for submitting billing for surgeries related to work-related injuries under the New York State Workers’ Compensation Law.
Under the law, authorized providers are reimbursed for their treatment of injured workers by the insurance carrier for the employer. Under the terms of his client agreements, Patel was supposed to submit bills for surgical procedures to insurance carriers, including NYSIF, the workers’ compensation carrier for these claims.
The payments would then be issued directly to the surgical practice or its doctors. In exchange for providing these billing services, Patel’s companies were paid monthly service fees by the doctors – often more than $13,000 per month.
After gaining the trust of the doctors, Patel abused his position as a billing agent by submitting hundreds of falsified claim forms to NYSIF, instructing that certain insurance checks be issued directly to his companies instead of to the doctors. Patel concealed his years-long scheme by diverting only a small percentage of the total insurance payments to himself. To further conceal his thefts, Patel forged one of the doctor’s signatures on claim forms.
Patel’s scheme came to light in 2018 when the office manager for the orthopedic practice noticed an incoming fax with a copy of a check made directly from NYSIF to one of Patel’s companies.
A forensic audit of the bank accounts for Patel and his businesses revealed that the stolen funds were deposited into Patel’s corporate accounts. Patel withdrew almost $1 million in cash from the accounts and used corporate credit cards to fund vacations to London, Portugal, and Las Vegas, as well as to finance luxury vehicles from Audi and Mercedes Benz.
In January 2024, Patel was arrested and arraigned before Judge Holly Trexler in Albany City Court. In March 2024, an Albany County grand jury charged Patel with 29 counts of Insurance Fraud in the First Degree, Grand Larceny in the First, Second, and Third Degrees, Forgery in the Second Degree, Scheme to Defraud in the First Degree, Falsifying Business Records in the First Degree, and Workers’ Compensation Fraud.
He pleaded guilty before Judge Andra Ackerman in Albany County Court on September 9, 2024, to one count of Insurance Fraud in the Second Degree (a Class C felony).
Patel was sentenced on December 9 by Judge Ackerman to 5 years of probation and a payment of $300,000 in restitution to the victim doctors. Patel previously paid additional restitution to the victim doctors in a prior private civil settlement.
