Physician Pays $95,000 to Resolve Allegations of Genetic Testing Fraud

PHILADELPHIA – United States Attorney Jacqueline C. Romero announced that Nishi Patel, MD, a physician who received his medical training at Drexel University, will pay $95,000 to resolve allegations that he violated the False Claims Act by ordering medically unnecessary genetic testing for Medicare beneficiaries.

Between August 2018 and May 2020, Dr. Patel referred more than 400 patients for medically unnecessary genetic tests that were paid for by Medicare. The United States alleges that Dr. Patel had no medical relationship with these patients, never examined these patients, and that the referrals were based on brief telemedicine consultations, and in some instances, no consultation. The genetic tests that Dr. Patel ordered often cost thousands of dollars per patient.

“Doctors who refer patients for medically unnecessary and costly services, such as genetic testing, deplete vital funds from Medicare and other government healthcare programs,” said U.S. Attorney Romero. “This office will continue to work with law enforcement partners, and our own internal analytics tools, to identify healthcare providers who increase costs through unnecessary procedures and will hold them accountable.”

“Accurately billing for services provided to Medicare beneficiaries is required of all health care providers,” said Maureen R. Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General, Region III. “HHS-OIG and the U.S. Attorney’s Office will continue to evaluate and pursue allegations of medically unnecessary services.”

This matter was handled by Assistant U.S. Attorney Deborah W. Frey and Auditor Dawn Wiggins.

The government’s pursuit of this matter illustrates its emphasis on combatting health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).