Luxurious Vehicles and Exotic Vacations Paid for by Stolen Money Intended for Surgeons
(WNY News Now) NEW YORKA, NJ — A man who took advantage of his job as a medical billing agent was punished for embezzling more than $1.1 million meant for surgeons who treat injured workers under the Workers’ Compensation Law in New York.
Today, Amrish Patel, 62, of Monroe Township, New Jersey, was found guilty and sentenced by New York Attorney General Letitia James and New York State Inspector General Lucy Lang of stealing over $1.1 million that was supposed to be paid directly to physicians who treated injured workers under the New York State Workers’ Compensation Law. By submitting fabricated claim forms to the New York State Insurance Fund (NYSIF), Patel, who worked as a billing assistant at an orthopedic surgery clinic in Brooklyn, stole at least $1.1 million in workers’ compensation claims from three physicians. Patel purchased expensive cars and trips with these pilfered monies. Today, Patel, who had earlier entered a guilty plea to one count of Insurance Fraud in the Second Degree, a Class C felony, was given a five-year probationary period and mandated to reimburse the victim doctors $300,000.
Attorney General James warned that stealing money intended to treat wounded workers hurts healthcare providers and jeopardizes a vital lifeline for New Yorkers. Amrish Patel grabbed over a million dollars meant for doctors who provided necessary care, but instead of using the money for the billing tasks he was supposed to undertake, he used it for lavish vacations and fancy cars. We will keep pursuing anyone who tries to take advantage of our health care system for their own benefit, and I thank our partners for their cooperation in this investigation.
The defendant’s actions damaged New Yorkers’ faith in our workers’ compensation system through a complex scam. He took advantage of weaker employees and denied medical professionals their due compensation by fabricating documents and transferring monies, according to New York State Inspector General Lucy Lang. The sentence imposed today makes it abundantly evident that anyone attempting to scam our systems will suffer dire repercussions. I applaud the cooperation between my office, NYSIF, and the Attorney General’s office in resolving this issue.
According to Gaurav Vasisht, CEO and Executive Director of the New York State Insurance Fund, NYSIF is steadfastly dedicated to combating workers’ compensation fraud. Every law-abiding person and employer in New York State bears the financial burden of these felonies, which also increase the cost of conducting business. We appreciate the dedication of the Inspector General and Attorney General to this inquiry.
The Office of the Attorney General’s (OAG) Criminal Enforcement and Financial Crimes Bureau (CEFC), the Office of the Inspector General’s (OIG) Workers’ Compensation Fraud section (WCFIG), and NYSIF conducted a combined investigation that led to today’s conviction. According to the investigation, Patel stole money meant for surgeons who treated patients claiming workers’ compensation benefits between January 2012 and January 2019, abusing his role as a medical billing agent.
Under the New York State Workers’ Compensation Law, Patel was in charge of filing bills for surgeries associated with work-related ailments. According to the law, the insurance company for the employer pays approved providers for treating wounded employees. Patel was required to submit surgical procedure bills to insurance companies, including NYSIF, the workers’ compensation carrier for these claims, in accordance with the provisions of his client agreements. The surgical practice or its physicians would then receive the cash directly. The doctors paid Patel’s companies monthly service fees, which were frequently more than $13,000, in exchange for these billing services.
Patel misused his role as a billing agent after winning the doctors’ trust. He sent hundreds of fabricated claim forms to NYSIF, directing that certain insurance checks be sent to his businesses rather than the doctors. Patel diverted only a small portion of the overall insurance payouts to himself in order to hide his years-long plan. Patel falsified one of the doctor’s signatures on claim forms in order to further hide his thefts.
When the orthopedic practice’s office manager saw an incoming fax containing a copy of a check issued straight from NYSIF to one of Patel’s firms in 2018, Patel’s plan eventually came to an end. Patel embezzled at least $1.1 million in payments for services rendered by three physicians between January 1, 2012, and January 4, 2019. The stolen money was transferred into Patel’s corporate accounts, according to a forensic examination of his and his companies’ bank accounts. Patel took nearly $1 million in cash out of the accounts and used business credit cards to finance expensive cars from Mercedes-Benz and Audi as well as trips to London, Portugal, and Las Vegas.
Patel was taken into custody and arraigned in Albany City Court before Judge Holly Trexler in January 2024. 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 were brought against Patel by an Albany County grand jury in March 2024. On September 9, 2024, Patel entered a guilty plea to one count of Insurance Fraud in the Second Degree, a Class C felony, before Judge Andra Ackerman in Albany County Court. Judge Ackerman sentenced Patel today to five years of probation and $300,000 in reparations to the doctors who were harmed. In an earlier private civil settlement, Patel gave the victim doctors more compensation.
Attorney General James expresses gratitude to OIG and NYSIF for their invaluable support in this case.
Assistant Attorney General Cheryl Lee of CEFC is prosecuting this case. Legal Analyst Brooke Starkey performed analytical work under the direction of Deputy Supervising Analyst Jayleen Garcia and Supervising Analyst Paul Strocko. Under the direction of the Forensic Audit Section’s Chief Auditor Kristen Fabbri and Deputy Chief Auditor Sandy Bizzarro, Principal Supervising Auditor Investigator Jason Blair carried out the forensic accounting. Bureau Chief Stephanie Swenton and Deputy Bureau Chief Joseph G. D. Arrigo are in charge of CEFC.
Detective Dennis Churns carried out the criminal investigation under the direction of Major Investigations Unit Assistant Chief Samuel Scotellaro and Deputy Chief Juanita Bright. Chief Investigator Oliver Pu-Folkes is in charge of the Investigations Bureau. The Division for Criminal Justice, headed by Chief Deputy Attorney General Jose Maldonado and supervised by First Deputy Attorney General Jennifer Levy, includes both CEFC and the Investigations Bureau.