Suburban Physician Indicted for Allegedly Pocketing Nearly $1 Million in Medicare and Insurer Payments for Nonexistent Treatment
CHICAGO — A suburban physician has been indicted on federal fraud charges for allegedly pocketing nearly $1 million in payments from Medicare and a private insurer for nonexistent treatment.
DR. PRANAV PATEL owned and operated Palos Medical Care, S.C., in Palos Heights. The 12-count indictment alleges that Dr. Patel submitted fraudulent claims for purported medical tests and examinations that were never performed. He allegedly used some of his patients’ names without their knowledge to submit fraudulent claims. From 2008 to 2013, Dr. Patel fraudulently obtained, or caused his clinic to obtain, at least $950,000 in payments from Medicare and Blue Cross and Blue Shield of Illinois, the indictment states.
The indictment was returned Thursday in U.S. District Court in Chicago. It charges Dr. Patel, 51, of Burr Ridge, with seven counts of health care fraud, three counts of making false statements in relation to a health care matter, and two counts of aggravated identity theft. Arraignment is set for May 15, 2018, at 8:45 a.m., before U.S. District Judge Amy J. St. Eve.
The indictment was announced by John R. Lausch, Jr., United States Attorney for the Northern District of Illinois; James Vanderberg, Special Agent-in-Charge of the Chicago Regional Office of the U.S. Department of Labor, Office of Inspector General; and Jeffrey S. Sallet, Special Agent-in-Charge of the Chicago office of the Federal Bureau of Investigation.
The indictment describes several instances in which Dr. Patel submitted a claim to BCBS or Medicare for a non-invasive “duplex scan” purportedly performed on a patient, when, in fact, no such test was actually completed. On at least one occasion, according to the charges, Dr. Patel prepared a seven-page electronic medical record indicating that a patient had come to the office for a follow-up visit and examination, when the patient had actually come to the office to re-fill a prescription.
The public is reminded that an indictment is not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.
Aggravated identity theft is punishable by a mandatory sentence of two years in prison. Health care fraud is punishable by up to ten years, while false statements carry a maximum of five years. If convicted, the Court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.
The government is represented by Assistant U.S. Attorneys Stephen Chahn Lee and Kaarina Salovaara.