Attorney General James and Inspector General Lang Announce Conviction of Medical Biller for Stealing More Than $1.1 Million from Surgeons Who Provided Care to Injured Workers

 

Amrish Patel Used Stolen Funds to Buy Luxury Vehicles and Vacations

New York Attorney General Letitia James and New York State Inspector General Lucy Lang today announced the conviction and sentencing of Amrish Patel, 62, of Monroe Township, New Jersey, for stealing more than $1.1 million that was intended to be paid directly to doctors who provided medical care to injured workers under the New York State Workers’ Compensation Law. Patel, who provided billing services to a Brooklyn-based orthopedic surgery practice, stole at least $1.1 million in workers’ compensation reimbursements from three surgeons by submitting falsified claim forms to the New York State Insurance Fund (NYSIF). Patel used these stolen funds to pay for luxury vehicles and vacations. Patel, who previously pleaded guilty to one count of Insurance Fraud in the Second Degree, a Class C felony, was sentenced today to five years of probation and ordered to pay $300,000 in restitution to the victim doctors.

 

“Stealing funds meant to provide care for injured workers harms medical professionals and puts a crucial lifeline for New Yorkers at risk,” said Attorney General James. “Instead of performing the billing services he was hired to do, Amrish Patel pocketed more than a million dollars intended for doctors who provided essential care, and then spent the money on luxury vehicles and expensive vacations. I thank our partners for their collaboration in this investigation, and we will continue to go after all those who attempt to cheat our health care system for personal gain.”

 

“Through an elaborate fraud, the defendant’s actions undermined the trust that New Yorkers place in our workers' compensation system. By falsifying records and diverting funds, he exploited vulnerable workers and deprived medical professionals of rightful payments,” said New York State Inspector General Lucy Lang. “Today’s sentencing sends a clear message that those who seek to defraud our systems will face severe consequences. I commend the collaborative efforts of the Attorney General’s office, NYSIF, and my office in bringing this matter to justice.”

 

"NYSIF is deeply committed to rooting out workers’ compensation fraud,” said New York State Insurance Fund Executive Director and CEO Gaurav Vasisht. “These felonies raise the cost of doing business and dip into the pockets of every honest citizen and employer in New York State. Thank you to the Attorney General and Inspector General for their commitment to this investigation."

  

Today’s conviction is the result of a joint investigation by the Office of the Attorney General’s (OAG) Criminal Enforcement and Financial Crimes Bureau (CEFC), the Offices of the Inspector General’s (OIG) Workers’ Compensation Fraud unit (WCFIG), and NYSIF. The investigation found that from January 2012 through January 2019, Patel abused his position as a medical billing agent by stealing payments that were intended for surgeons who provided care to those claiming workers’ compensation benefits.

 

Patel was responsible for submitting billing for surgeries related to work-related injuries under the New York State Workers’ Compensation Law. Under the law, authorized providers are reimbursed for their treatment of injured workers by the insurance carrier for the employer. Under the terms of his client agreements, Patel was supposed to submit bills for surgical procedures to insurance carriers, including NYSIF, the workers’ compensation carrier for these claims. The payments would then be issued directly to the surgical practice or its doctors. In exchange for providing these billing services, Patel’s companies were paid monthly service fees by the doctors – often more than $13,000 per month.

After gaining the trust of the doctors, Patel abused his position as a billing agent by submitting hundreds of falsified claim forms to NYSIF, instructing that certain insurance checks be issued directly to his companies instead of to the doctors. Patel concealed his years-long scheme by diverting only a small percentage of the total insurance payments to himself. To further conceal his thefts, Patel forged one of the doctor’s signatures on claim forms.

In 2018, Patel’s scheme finally unraveled when the office manager for the orthopedic practice noticed an incoming fax with a copy of a check made directly from NYSIF to one of Patel’s companies. In total, Patel stole at least $1.1 million in payments intended for three doctors for services provided between January 1, 2012, and January 4, 2019. A forensic audit of the bank accounts for Patel and his businesses revealed that the stolen funds were deposited into Patel’s corporate accounts. Patel withdrew almost $1 million in cash from the accounts and used corporate credit cards to fund vacations to London, Portugal, and Las Vegas, as well as to finance luxury vehicles from Audi and Mercedes Benz.

In January 2024, Patel was arrested and arraigned before Judge Holly Trexler in Albany City Court. In March 2024, an Albany County grand jury charged Patel with 29 counts of Insurance Fraud in the First Degree, Grand Larceny in the First, Second, and Third Degrees, Forgery in the Second Degree, Scheme to Defraud in the First Degree, Falsifying Business Records in the First Degree, and Workers’ Compensation Fraud. Patel pleaded guilty before Judge Andra Ackerman in Albany County Court on September 9, 2024, to one count of Insurance Fraud in the Second Degree (a Class C felony). Patel was sentenced today by Judge Ackerman to 5 years of probation and a payment of $300,000 in restitution to the victim doctors. Patel previously paid additional restitution to the victim doctors in a prior private civil settlement.

 

Attorney General James thanks NYSIF and OIG for their valuable assistance on this case. In turn, Inspector General Lang expressed her appreciation to OAG, NYSIF, and especially the members of her staff responsible for this investigation, particularly Attorney-in-Charge for Workers’ Compensation Fraud Bryan Richmond, and Investigators James Pescetti and Lisa Lingenfelter.

 

The criminal investigation was conducted by Detective Dennis Churns, under the supervision of Deputy Chief Juanita Bright and Assistant Chief Samuel Scotellaro of the Major Investigations Unit. The Investigations Bureau is led by Chief Investigator Oliver Pu-Folkes. Both CEFC and the Investigations Bureau are part of the Division for Criminal Justice, which is led by Chief Deputy Attorney General Jose Maldonado and overseen by First Deputy Attorney General Jennifer Levy.

 

To file a complaint with the Inspector General regarding corruption, fraud, or abuse in state government or the Workers’ Compensation and Welfare Systems, call 1-800-DO-RIGHT or visit ig.ny.gov. Follow the office’s work on social media at @NewYorkStateIG.