United States Settles Claims of Durable Medical Equipment Fraud Against Wilmington Physician

WILMINGTON, Del. - U.S. Attorney David C. Weiss announced today that Dr. Vishal Patel, a Wilmington physician, has agreed to pay $1,080,000 to resolve allegations that he violated the False Claims Act by ordering medically unnecessary durable medical equipment for patients covered by Medicare and the Federal Employees Health Benefits Program (FEHBP).

Between February 2018 and April 2019, Dr. Patel referred patients for more than 1750 orthotic devices, including wrist, shoulder, knee, ankle, and back braces. The United States alleges that Dr. Patel had no medical relationship with these patients and that the referrals were based on brief reviews of the patients' medical charts, which failed to establish any legitimate medical justification for the devices. Medicare and FEHBP paid, on average, more than $400 for each device. Patient files were provided to Dr. Patel by RediDoc, LLC, a purported telemedicine company based in Phoenix, Arizona whose owners pleaded guilty to participation in a $64 million health care fraud conspiracy in May 2022.

"Fraudulent telemedicine companies such as RediDoc rely on licensed healthcare providers to make their operations appear legitimate and avoid detection," said U.S. Attorney Weiss. "By ordering services for patients they have never examined or treated, these providers permit fraud schemes to flourish and drain vital funds from Medicare and other government healthcare programs. In conjunction with our law enforcement partners, this office will continue to use all available means to identify healthcare providers who increase costs through unnecessary orders and hold them accountable."

"For more than a year, Dr. Patel schemed to deceive and repeatedly lied to further his greed. His blatant and unscrupulous abuse of the healthcare system led to an exorbitant amount of fraud," said Special Agent in Charge William J. DelBagno of the FBI Baltimore Field Office. "Healthcare fraud takes money away from legitimate patients and needs, affecting the reliability of our programs, which is why the FBI is committed to bringing fraud to light and perpetrators like Dr. Patel to justice."

"We expect that federal health care providers submit necessary orders for patients they are actually treating," said Derek M. Holt, Special Agent in Charge, the Office of Personnel Management Office of the Inspector General. "We applaud our law enforcement partners and colleagues at the Department of Justice for their hard work in protecting the FEHBP and other federal health care programs from fraudulent claims."

"Health care providers are required to charge Medicare only for services and equipment that are medically necessary," said Maureen R. Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG). "HHS-OIG, the U.S. Attorney's Office, and our law enforcement partners will continue to pursue allegations that illegitimate billings have been submitted to federal health care programs."

This matter was investigated by agents from the FBI, HHS-OIG, and the Office of Personnel Management Office of the Inspector General. Within the U.S Attorney's Office, this matter was handled by Civil Chief Dylan J. Steinberg and Affirmative Civil Enforcement Auditor David Cheung.

The government's pursuit of this matter illustrates its emphasis on combating 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).

The claims resolved by the settlement are allegations only and there has been no determination of liability.

A copy of this press release is located on the website of the U.S. Attorney's Office for the District of Delaware.

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