According to Department of Justice press release issued December 6, 2016, Vijay Patel and Mobile Diagnostic Testing of NJ LLC, Patel’s diagnostic testing company are being sued under the False Claims Act for knowingly submitting false claims to Medicare for thousands of diagnostic testing services he did not render.  Patel pleaded guilty on December 15, 2014, to a criminal information charging him with health care fraud related to the scheme.  Now, a civil complaint is alleging Vijay Patel violated the False Claims Act  based on the same conduct.

According to the government’s complaint, Patel associated with a cardiologist, who was also a participant in the Medicare program.   From August 2011 through December 2012, Patel and the cardiologist defrauded Medicare by submitting claims to Medicare for diagnostic testing services that the doctor had performed in December 2010 through September 2012, enabling him to evade Medicare’s pre-payment review.  Patel submitted the cardiologist’s claims through his company and his brother’s company, Biosound Medical Services Inc. (Biosound), as if Mobile Diagnostic and Biosound had performed the services instead of the doctor. Once Patel received the Medicare reimbursement money paid to the two companies for diagnostic testing services the cardiologist had performed, Patel transferred a portion of the payment to the doctor and kept a substantial portion for himself.

As reported by fraudblawg, in August 2016 Patel’s brother Kirtish N. Patel, owner of Biosound, and his wife Nita K. Patel were sentenced to 100 months and 78 months in federal prison, respectively, due to related schemes.  The husband and wife duo were also ordered to pay $4.8 million in restitution.  Similar to the current case filed against Vijay Patel, Kirtish and Nita Patel also faced a separate civil False Claims Act case which resulted in Kirtish and Nita Patel being ordered to pay $5 million in damages and $2.75 million in civil monetary penalties.

The civil False Claims Act case against Kirtish and Nita Patel was filed under the qui tam provisions of the False Claims Act.  The qui tam provisions allow private citizens with knowledge of fraud against the government to bring civil actions on behalf of the United States and to share in any recovery the government makes. The whistleblower in that case was a former employee of Biosound Medical Services.   Successful False Claims Act whistleblowers are entitled to 15-30% of the government’s recovery as well as their attorney’s fees.  The False Claims Act also allows the government to file a False Claims Act case on its own, as it did in this case.