New York, NY – New York Attorney General Letitia James recently announced the arrest and arraignment of Amrish Patel of Monroe Township, New Jersey, for allegedly stealing more than $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, allegedly submitted falsified claim forms to the New York State Insurance Fund (NYSIF) to steal at least $1.1 million in workers’ compensation reimbursements for himself. Patel and his two companies, Medlink Services, Inc. and Medlink Partners, LLC (together, Medlink), were charged with 27 felony counts for the thefts they allegedly committed from January 2012 through January 2019.
“Doctors and health care professionals provide crucial care to our communities, and they rely on accurate and ethical billing to sustain these services and ensure our wellbeing,” said Attorney General James. “When money is illegally diverted away from doctors and providers, all New Yorkers suffer as a result. Fraud of any kind will never go unchecked in our state, and my office will continue to use every measure to hold accountable those who seek to cheat New Yorkers for personal gain. I thank our partners for their invaluable support and collaboration on this case.”
“Fraud in any part of the workers’ compensation system is detrimental to trust and hurts the entire system, including medical providers, carriers, businesses, and injured workers,” said New York State Insurance Fund Executive Director and CEO Gaurav Vasisht. “I am thankful for the collaboration of the Attorney General and Inspector General’s offices on this investigation.”
“Workers’ compensation fraud is not a victimless crime,” said New York State Inspector General Lucy Lang. “The defendant compromised the integrity of this crucial safety net when he took advantage of his trusted position to ensure accurate billing for medical providers and health insurers. I am grateful to the Office of the Attorney General and the New York State Insurance Fund for their partnership in rooting out this fraud.”
As outlined in the 27-count complaint, Patel abused his position as a medical billing agent over the course of nearly seven years by diverting payments that were intended for surgeons who provided health care services to workers’ compensation claimants. Starting in 2011, Patel and his companies handled billing services for a Brooklyn-based orthopedic surgery practice and were 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 their client agreement, Patel submitted bills for surgical procedures to NYSIF, the workers’ compensation carrier in this instance, and then the payments would subsequently be issued directly to the surgical practice or its doctors. In exchange for these transactions, Patel and his companies were paid monthly service fees. However, Patel allegedly submitted falsified claim forms to NYSIF and requested that the payments be sent to his companies instead of the doctors. In total, Patel allegedly stole at least $1.1 million in payments originally intended for three doctors for services provided between January 1, 2012 and January 4, 2019.
Patel was arraigned before the Honorable Holly Trexler in Albany City Court. Patel and the companies were charged with one count of Insurance Fraud in the First Degree (Class B felony), one count of Grand Larceny in the First Degree (Class B felony), one count of Grand Larceny in the Second Degree (Class C felony), one count of Grand Larceny in the Third Degree (Class D felony), one count of Scheme to Defraud in the First Degree (Class E felony), 11 counts of Falsifying Business Records in the First Degree (Class E felony), and 11 counts of Workers’ Compensation Fraud (Class E felony). Patel was released with electronic monitoring and a $100,000 bond.
The charges are merely accusations, and the defendants are presumed innocent unless and until proven guilty in a court of law.
The charges are the result of a joint investigation by the Office of the Attorney General’s (OAG) Criminal Enforcement and Financial Crimes Bureau (CEFC), NYSIF, and the New York State Offices of the Inspector General (OIG).
Attorney General James thanks NYSIF and OIG for their valuable assistance on this case.
Inspector General Lucy Lang thanked Attorney-in-Charge for Workers’ Compensation Fraud Bryan Richmond and Investigators James Pescetti and Lisa Lingenfelter for their work on this case.
This case is being prosecuted by Assistant Attorney General Cheryl Lee of CEFC. Analytical work was provided by Legal Analyst Brooke Starkey, under the supervision of Supervising Analyst Paul Strocko and Deputy Supervising Analyst Jayleen Garcia. Forensic accounting was conducted by Principal Supervising Auditor Investigator Jason Blair, under the supervision of Deputy Chief Auditor Sandy Bizzarro of the Forensic Audit Section. CEFC is led by Bureau Chief Stephanie Swenton and Deputy Bureau Chief Joseph G. D’Arrigo.
The criminal investigation was conducted by Detective Dennis Churns, under the supervision of Deputy Chief Juanita Bright and Assistant Chiefs Samuel Scotellaro and Mitchell Paurowski 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.
Source: NY AG’s Office