Baltimore, Maryland - US District Judge George L Russell III
sentenced Jigar Patel, 27, of Columbia, Maryland, to 13 months in prison,
followed by three years of supervised release, for a scheme to defraud
Medicaid, Medicare and the Federal Employees Health Benefits Program by
submitting false claims for prescription refills.
As a result of the scheme, the loss to the health care
benefit programs is between $2.5 million and $7 million. Judge Russell ordered
Jigar Patel to pay $102,066.25.
The sentence was announced by United States Attorney for the
District of Maryland Rod J. Rosenstein and others.
Patel is a citizen of, and a licensed pharmacist in India, working in the United States under an H1-B visa. He
was hired as a pharmacy technician in 2010, by Reddy Vijay Annappareddy, the
owner of Pharmacare, LLC, who agreed to sponsor his work permit.
According to his plea agreement, Patel held the position of
lead pharmacy technician, starting at $10/hour and eventually becoming a
salaried employee, making approximately $1,400 biweekly. In addition, Patel was
provided with housing and transportation, making his total salary and benefits
between $70,000 and $120,000. The value of the housing and transportation
benefits were not disclosed on Patel’s income tax returns.
Patel admitted that he billed insurance programs for
prescription refills when the pharmacy customers had not requested the refill.
As soon as a prescription was eligible for refill, Patel would cause a false
claim to be electronically submitted to a health care benefit program.
These refills were often billed and filled without the
customer’s knowledge. The medications targeted for automatic refills were
typically expensive HIV and cancer medications used by very ill customers. The
claims for payment were not reversed when the customers did not receive the
medications, which the customers had not requested in the first place. Patel
also knew that medications filled but not delivered to the customer – usually
because the customer had not requested the refill – were placed back on the
shelves at the pharmacy to be re-used to fill other prescriptions.
For example, Patel submitted false claims for prescriptions
in the name of a Pharmacare customer. When the customer complained to Patel
that Pharmacare was billing for refills that she received from her mail order
pharmacy, Patel sent an email to Annappareddy documenting the fact that
Pharmcare was billing and not reversing “high dollar†prescriptions in order to
increase the volume of business at Pharmacare. Patel also asked Annappareddy
for guidance on how to handle the customer’s complaint. In the same time frame,
Patel asked Annappareddy for a “bonus†for his “work performance†in order to
“solve some of my financial problems†because he “fulfill[ed]†Annappareddy’s
requirements to “grow†Pharmacare’s business.
In August 2013, a federal search warrant was executed at a
then vacant home that was used by Annappareddy to house Pharmacare employees,
and in which Patel previously resided. During the search, federal agents
recovered undelivered medications worth approximately $87,749.48, as well as
binders of alphabetically arranged signature logs which purported to confirm
the delivery of medication to Pharmacare customers. However, the signature
pages were undated and contained only the customer’s name and signature. Many
of the undelivered medications found at the home were actually billed and
filled by Jigar Patel in his capacity as pharmacy technician.
Patel did not receive the profits from the fraud scheme
directly, but was able to keep his job at Pharmacare and lawfully remain in the
United States
on an H1-B visa.
Reddy Vijay Annappareddy, age 46, of Fallston, Maryland,
was convicted on December 15, 2014, after a five week trial, on charges of
health care fraud and aggravated identity theft in connection with the scheme.
Annappareddy faces a maximum sentence of 10 years in prison for health care
fraud and a mandatory minimum of two years in prison, consecutive to any other
sentence imposed, for aggravated identity theft, plus a $250,000 fine. Judge
Russell has scheduled sentencing for Annappareddy on March 11.
Additionally, Vipinkumar Patel, 31, of Edgewood,
Maryland, Ram Guruvareddy, 59, of Belcamp, Maryland, and
Venkata Srinivas Mannava, 45, of Hyattsville,
Maryland, pled guilty to their
roles in the scheme, and testified at the trial to their knowledge of the
scheme.
Judge Russell sentenced Guruvareddy to five years probation
and ordered him to pay a fine of $20,000.
