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A financial advisor in West New York has been found guilty of defrauding public health insurance plans of over $4 million. Kaival Patel, 54, was convicted on multiple charges including wire and healthcare fraud, conspiracy, and money laundering after an 11-day trial. Patel was accused of orchestrating an elaborate healthcare fraud scheme that targeted public employees, particularly corrections officers, directing them to a family member’s medical office in Newark. From there, Patel and a co-conspirator inflated charges for compound prescription medications, such as vitamins, pain creams, and reflux medication, and submitted fraudulent reimbursement claims to insurance providers.
The evidence presented against Patel revealed that he received commissions from these bogus prescriptions and enlisted a group of corrections officers to act as recipients and fill the fraudulent prescriptions. The scheme operated under the name ABC Healthy Living, where compound medications had to be mixed a pharmacist to suit specific medical needs. By exploiting insurance plans, Patel and his co-conspirator were able to secure thousands of dollars in reimbursements for one-month supplies of these medications.
“While our client is disappointed with the jury’s decision, we are considering all options, including an appeal,” said Bob Stahl, Patel’s attorney. Sentencing is set to take place in April.
This case is part of a broader conspiracy investigation, resulting in 47 convictions or guilty pleas thus far. Public health insurance fraud is a serious offense that not only defrauds insurance providers but also drains resources that should be allocated to legitimate healthcare needs. Authorities are continuing to crack down on such schemes to protect the integrity of healthcare programs.
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