Druggists defraud insurers

A Medicaid auditor stopped by unannounced one day at the Rx Shop pharmacy in Clearwater.

The owner, Jatin Patel, feared he might be discovered.

He had been stealing from Medicaid, Medicare and Tricare, the military insurance program, by submitting fraudulent reimbursement requests for prescriptions he never filled.

Somehow, he persuaded the auditor to leave and return the next day.

Then he called two other pharmacists and asked them what to do.

The two, Rajnish Mehta and Satender Singh, arrived the next day with a stack of forged prescriptions to support the claims, according to court documents.

Patel later told investigators the two had given him the names of beneficiaries he used to submit fraudulent claims for $260,000. He said he split the money with them.

All three men, as well as two other pharmacists, have since been arrested and charged with perpetrating what authorities say is an emerging type of fraud - using fabricated prescriptions to steal from government health insurance programs.

Targeted by a regional Medicare Fraud task force, the pharmacists are accused of stealing more than $1.5 million by submitting hundreds of false prescription claims between 2006 and 2008.

The use of prescription billing to defraud the government is becoming pervasive, especially since the enactment of Medicare Part D, the prescription program created in 2006, authorities said.

"The more you look, the more you find," said Ryan Lynch, assistant special agent in charge of the Tampa office of the Office of Inspector General, the law enforcement arm of the U.S. Department of Health and Human Services.

Paying the consequences

Patel, 37, of Seminole, pleaded guilty to making a false statement to a federal health care program and is serving seven months in federal prison.

He received a lower sentence because his cooperation helped lead to the other arrests, according to the U.S. Attorney's Office.

Mehta, 33, of Trinity, is trying to negotiate a plea deal, his attorney said.

"I don't think he's going to go to trial," said Bjorn Brunvand.

Singh, 34, of Summerfield in Marion County, is awaiting trial, as is pharmacist Naresh Jain, 37, of Trinity.

Sachin Amin, 35, of Largo, pleaded guilty to two counts of lying to a federal health care program and is serving 18 months in prison. Like Patel, he cooperated with authorities.

After emigrating from India in 1997, Amin built a mini business empire in Pinellas County, including a pharmacy, an assisted living facility, a restaurant and an ice cream franchise.

He used his Madeira Beach Rx Shop pharmacy to fraudulently bill Medicare and Medicaid for more than $738,000 worth of prescriptions he never filled, documents state.

As part of their sentences, Amin and Patel were ordered to repay the money they stole. Amin also likely faces deportation, said his attorney, Brunvand.

Attorneys for the other pharmacists either could not be reached or declined comment.

According to court papers, the five pharmacists have ties to each other.

After interning with Amin at Madeira Beach Rx Shop, Singh worked part time at Patel's Clearwater pharmacy. He then joined with Mehta to open Pasco Pharmacy in New Port Richey.

Mehta and Jain operated the Drugstore Healthmart pharmacy in Hudson, and Mehta and Singh opened Rx Care Pharmacy in Lady Lake in April 2007.

How the scheme worked

The pharmacists often shared names of patients who subscribed to government insurance programs, using the names to bill for expensive drugs that were never provided.

Mehta told investigators he stole Tricare patient names from a chain pharmacy where he worked for two years before opening his own business, court records state.

Between November 2007 and September 2008, Mehta submitted 40 claims totaling $25,700 for a Tricare patient for his Port Richey pharmacy, according to a complaint affidavit. Investigators said the patient had never been to Mehta's pharmacy but had gone to the chain where Mehta used to work.

In some cases, authorities say, the pharmacists made up customer names to bill for prescriptions. In other cases, they used the names of their customers to bill for drugs the patients never received.

Lynch said the investigation continues to grow.

"We've identified a new area of fraud in our community," he said. "We're on the cusp of it."