A 50-year-old Canton pharmacist who owned and operated 26 pharmacies in the metro Detroit area was sentenced Friday to 17 years in federal prison after being convicted in an elaborate scheme.
U.S. District Judge Arthur Tarnow, who sentenced Babubhai "Bob" Patel on 26 convictions for a health care fraud conspiracy, a drug conspiracy, and related fraud and drug violations, had harsh words for the man.
"What you have done is reprehensible," the judge said, adding that he's seen other heath care frauds in the past, but that they've all been "small scale compared to this."
In addition to the prison sentence, Patel also was ordered to pay $17.3 in restitution to the federal Medicaid and Medicare programs and an additional $1.5 million in restitution to Blue Cross Blue Shield.
According to the U.S. Attorney's Office, evidence presented at a six-week jury trial showed that between 2006 and 2011, Patel's pharmacies billed Medicare and Medicaid for more than $57 million.
At least a quarter of those billings were for drugs that were either medically unnecessary never dispensed. Additional amounts were fraudulently billed to private insurers, such as Blue Cross Blue Shield of Michigan.
The pharmacies operated on a business model that paid kickbacks to physicians in exchange for writing prescriptions for expensive medications. The affiliated doctors also would write prescriptions for controlled substances, without regard to medical necessity, which would be filled at the pharmacies and distributed to paid "patients" and patient recruiters. The expensive non-controlled medications would be billed but not dispensed.
“Taxpayers fund Medicare and Medicaid to provide health care to needy Americans,” U.S. Attorney Barbara McQuade said in a written statement. “It is gratifying to see courts impose strong sentences on defendants who exploit these programs for personal gain.”
Patel is one of 26 people indicted in this scheme. Of those, 20 have either pleaded guilty or been convicted at trial. The remaining six are scheduled for trial in June.
Of 12 pharmacists charged, 11 have been convicted at trial or pleaded guilty, with one waiting to be tried. Of four doctors charged, two have pleaded guilty, with two waiting to be tried.
Earlier last week, Tarnow sentenced several of the other pharmacists who were convicted at trial.
Brijesh Rawal, 36, of Canton; Ashwini Sharma, 34, of Novi; and Lokesh Tayal, 36, of Northville, were each sentenced to 68 months in prison. All three are non-U.S. citizens who entered the United States under a visa program for certain skilled workers. Once their prison time has been served, each will be deported to the country of their citizenship. Rawal is a Canadian citizen and Sharma and Tayal are both from India.
"Those individuals who engaged in this health care fraud scheme stole millions of dollars over several years, from a system designed to provide health care to those in need," FBI Special Agent in Charge Robert Foley III said in a written statement. "The FBI is committed to stopping these illegal acts and prosecuting these criminals."