Psychologist among 26 defendents convicted in health care fraud scheme

July 11, 2013

The following story, from a news release by the Detroit office of the F.B.I., regards the last three of 26 defendants convicted in a fraud case.  Among them is psychologist Sanyani Edwards. Evidence presented at trial showed that Edwards offered and paid bribes and kickbacks to doctors, nurses, and assisted living facility owners in exchange for referrals of prescriptions to pharmacies owned by Babubhai Patel, who was also convicted in the scheme. Edwards also worked with a corrupt psychiatrist (as yet unnamed) to write fictitious prescriptions for patients, which could then be billed at a Patel pharmacy.

Story:

A podiatrist, a psychologist, and a pharmacist were convicted today in federal court in Detroit, Michigan, for health care fraud and controlled substance distribution, United States Attorney Barbara L. McQuade announced today.

McQuade was joined in the announcement by Special Agent in Charge Robert L. Corso, Drug Enforcement Administration, Detroit Division; Special Agent in Charge Robert D. Foley, III, Federal Bureau of Investigation; and Lamont Pugh, III, Special Agent in Charge, Department of Health and Human Services Office of Inspector General (HHS-OIG).

United States Attorney Barbara L. McQuade stated, “Law enforcement investigators in metro-Detroit are aggressively investigating health care fraud and detecting abuses by doctors and pharmacists. We hope that prosecutions like this one will deter medical professionals from stealing taxpayer funds intended for health care.”

Convicted were podiatrist Anmy Tran, 42, of Clinton Township, psychologist Sanyani Edwards, 34, of Southfield, and pharmacist Mitesh Patel, 39, of Troy. Defendants Tran and Edwards were convicted on all three of the counts with which they were charged, specifically, conspiracies to commit health care fraud, to distribute controlled substances, and to pay or receive health care kickbacks. Defendant Patel was convicted of six of the seven counts with which he was charged, specifically, health care fraud conspiracy, conspiracy to distribute controlled substances, and two substantive counts each of health care fraud and controlled substances distribution.

Defendant Mitesh Patel was acquitted of conspiracy to pay or receive health care kickbacks.

The evidence presented during the three-week trial demonstrated that, from approximately January 2006 through August 2011, Canton Pharmacist Babubhai Patel owned and controlled over 20 pharmacies (termed “the Patel Pharmacies” at trial), which operated in and around Detroit, Michigan. The evidence also showed that Babubhai Patel’s model for turning a profit at his pharmacies was based upon large-scale health care fraud and the diversion of controlled substances. Babubhai Patel paid cash kickbacks and other things of value to physicians in exchange for those physicians writing prescriptions for expensive medications, without regard to medical necessity, that could be billed to Medicare, Medicaid, or a private insurer through one of the Patel Pharmacies. Physicians affiliated with Babubhai Patel would also write prescriptions for controlled substances for their patients, again regardless of medical necessity, which would then be filled at one of the Patel Pharmacies. These controlled substances were distributed to patients and patient recruiters as a kickback in exchange for the patients using a Patel Pharmacy. Pharmacists at the Patel Pharmacies would increase the pharmacies’ profits by billing insurers for medications never actually distributed to patients.

The evidence presented at trial showed that defendant Anmy Tran was one of the physicians to whom Babubhai Patel paid bribes and kickbacks in exchange for referrals of prescriptions. In exchange, Tran wrote numerous prescriptions for expensive medications, without regard to medical necessity, that could be filled at one of the Patel Pharmacies. Evidence presented at trial demonstrated that defendant Mitesh Patel, a pharmacist in Babubhai Patel’s organization, billed Medicare, Medicaid, and private insurers for expensive medications he never dispensed to patients. With respect to Sanyani Edwards, the evidence presented at trial showed that he offered and paid bribes and kickbacks to doctors, nurses, and assisted living facility owners in exchange for referrals of prescriptions to the Patel Pharmacies. Edwards also worked with a corrupt psychiatrist to write fictitious prescriptions for patients, which could then be billed at a Patel Pharmacy.

Defendants Tran, Edwards, and Mitesh Patel were three of 26 individuals who were charged in August 2011 with offenses relating to their involvement with Babubhai Patel’s pharmacy network. All 26 of the original defendants have now been convicted of felonies arising out of their involvement with Babubhai Patel; 17 of those defendants entered guilty pleas, and nine, including the three defendants today, have been convicted after trial. Defendant Babubhai Patel was convicted at a trial in August 2012; he is serving a 17-year prison sentence. A superseding indictment charging 13 additional individuals was unsealed in March 2013; those defendants’ cases remain pending, with a trial date set for January 2014.

The case was prosecuted by Assistant United States Attorneys John K. Neal and Wayne F. Pratt.

Source: "Jury Convicts Podiatrist, Psychologist, and Pharmacist in Health Care Fraud Case," news release of the F.B.I. Detroit Division, July 10, 2013.