Fraud in healthcare and workers’ compensation systems can harm professionals and those who depend on them.
Amrish Patel, a medical biller, stole over $1.1 million that was supposed to go to surgeons, and it clearly shows how trust can be abused.
We’re about to explain what he did, how he was caught, and the punishment he faced.
- Amrish Patel stole over $1.1 million intended for surgeons caring for injured workers.
- Patel used the stolen funds for expensive vacations and high-end cars like Audi and Mercedes-Benz.
- Patel pleaded guilty, received five years of probation, and was ordered to repay $300,000 in restitution.
One Medical Biller Exploited Trust to Steal Millions
Amrish Patel, a 62-year-old from Monroe Township, New Jersey, was sentenced for stealing more than $1.1 million intended for surgeons treating injured workers under New York’s Workers’ Compensation Law.
As a billing agent for a Brooklyn orthopedic surgery practice, Patel submitted false insurance claims to divert funds to his companies.
The money stolen over seven years funded Patel’s luxurious lifestyle, including expensive vacations and luxury cars.
Patel pleaded guilty to Insurance Fraud in the Second Degree, a Class C felony, and was sentenced to five years of probation.
He was ordered to pay $300,000 and had previously paid additional restitution in a civil settlement.
How the Fraud Was Committed
From January 2012 to January 2019, Patel was responsible for billing insurance claims for surgeries under New York’s Workers’ Compensation Law.
This law ensures that medical providers are reimbursed directly by the insurance carriers for treating injured workers.
Patel’s role was to submit accurate claims and forward the payments to surgeons.
Instead of following the rules, Patel submitted false claims to the New York State Insurance Fund (NYSIF), instructing that payments be sent to his companies.
He forged signatures on claim forms to avoid detection and diverted only small portions of the total payments.
Patel received over $13,000 in monthly service fees from the surgeons, who trusted him to manage their claims properly.
Discovery and Investigation
Patel’s fraud was exposed in 2018 when an office manager at the orthopedic practice noticed a suspicious fax showing an NYSIF-issued check made out to Patel’s company.
It led to an investigation by the New York Attorney General’s Office, the New York State Inspector General’s Workers’ Compensation Fraud Unit, and NYSIF.
A forensic audit revealed Patel deposited stolen payments into his business accounts.
And nearly $1 million in cash was withdrawn from these accounts.
Patel used corporate credit cards to pay for international vacations to London, Portugal, and Las Vegas, as well as to purchase luxury vehicles, including an Audi and a Mercedes-Benz.
Legal Proceedings
In January 2024, Patel was arrested and arraigned in Albany City Court before Judge Holly Trexler.
By March 2024, he faced 29 charges, including:
- Insurance Fraud in the First and Second Degrees
- 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
- Workers’ Compensation Fraud
On September 9, 2024, Patel pleaded guilty to one count of Insurance Fraud in the Second Degree, a Class C felony.
On December 11, 2024, Judge Andra Ackerman sentenced him to five years of probation and ordered him to pay $300,000 in restitution to the affected doctors.
He had previously paid additional restitution as part of a private civil settlement.
How Patel’s Actions Affected the System and the Response
Patel’s fraud delayed payments to surgeons and weakened the workers’ compensation system, which is designed to help injured workers and support healthcare providers.
Investigators had to spend significant time and resources tracking the stolen money and ensuring Patel faced justice.
The New York Attorney General’s Office and the Inspector General’s Workers’ Compensation Fraud Unit worked together to uncover the scheme.
These organizations partnered with the New York State Insurance Fund to investigate and prosecute Patel’s fraudulent activities.
Then, Attorney General Letitia James pointed out that Patel’s theft endangered the stability of the healthcare system by misusing funds meant for critical medical care.
NYSIF Executive Director Gaurav Vasisht explained that this type of fraud affects everyone, increasing costs for businesses and citizens across the state.
Amrish Patel’s fraud shows how healthcare and workers’ compensation systems can be abused.
While his sentencing ends seven years of theft, it also shows how legal and regulatory agencies work hard to protect and keep these systems fair.
