An Indian-origin doctor in the has agreed to pay $14 million to settle allegations of widespread healthcare fraud involving medically unnecessary procedures and false billing.
According to a by the , Jitesh Patel, along with his practice, Advanced Urology Inc. and affiliated entities, will pay the settlement amount to resolve claims under the False Claims Act and the Georgia False Medicaid Claims Act. Federal authorities alleged that the practice billed government healthcare programmes, including Medicare and Medicaid, for procedures that were either not performed or were medically unnecessary.
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What are the allegations against Dr Patel?
The investigation began after two whistleblower complaints were filed – one by a former employee and another by a former physician at the clinic. Both alleged that the organisation was “designed to maximize revenue for Dr. Patel and others by performing medically unnecessary procedures and tests.”
Among the practices highlighted were the implantation of devices in some patients without properly checking if they would actually benefit from them. Patients were also made to undergo unnecessary tests, some of which required them to be put under anaesthesia.
The complaint also alleged that the clinic ordered thousands of ultrasound tests that were not needed. In fact, every new patient was allegedly required to undergo one such test, even though it is not commonly used in regular urology practice. Moreover, thousands of ultrasound tests were reportedly ordered without medical necessity. Whistleblowers further claimed that in some cases, the clinic billed for procedures that were never performed.
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Whistleblowers to receive $2.94 million from the settlement
The case was investigated by multiple US agencies, including the US Attorney’s Office, the , and the Department of Health and Human Services. US Attorney Theodore S. Hertzberg said authorities would act firmly against such violations.
“Physicians commit fraud when they seek payment for medically unnecessary procedures or bill for services they never performed,” he said, adding that misuse of government funds and patient abuse would not be tolerated.
Notably, the case falls under the False Claims Act, which allows private individuals to file lawsuits on behalf of the government. Those who come forward, known as whistleblowers or relators, are entitled to a share of any recovered funds. In this case, the whistleblowers will receive a combined $2,940,000 from the settlement.
Authorities noted that the settlement resolves allegations only, and there has been no formal determination of liability.
