A former adviser to Stifel, Wells Fargo and Morgan Stanley will spend 3 1/2 years in prison for helping run a scheme that defrauded public health insurance plans of $4 million.
In addition to the 41-month prison sentence, a New Jersey federal judge ordered Kaival Patel to pay $4.72 million in restitution to the victims of his scheme. Patel was convicted last December on one count of conspiracy to commit wire fraud, health care fraud and several counts of money laundering.
“This defendant lined his own pockets by benefiting from health insurance plans for New Jersey state and local government employees, defrauding them of millions of dollars by conspiring to obtain reimbursements for medically unnecessary prescription drugs,” the statement said. a statement by US Attorney Phillip Sellinger. .
According to the Justice Department, Patel created a company with his wife to market complex prescription medications. Compounded medications are special medications mixed by pharmacists for specific patient needs and require a doctor's prescription.
In 2015, Patel and others learned that some New Jersey state insurance plans would reimburse government workers thousands of dollars for some complex prescription medications, including vitamins, scar creams, pain and libido creams, and drugs for acid reflux, according to DD.
So Patel devised a plan to prescribe complex medications to patients who didn't need them so he could get commissions on the drugs.
But the conspirators needed a doctor, so Patel went to Saurabh Patel, a Newark-based doctor (and relative of the defendant). Saurabh Patel admitted to signing the wrong prescriptions (and later pleaded guilty to insurance fraud, according to the DOJ).
Kaival Patel then paid a group of correctional officers to visit the doctor to get the wrong prescriptions. The defendant also conspired with a pharmacist to add unnecessary ingredients to the drugs to increase his costs (and his profits) even more.
According to SEC filings, Kaival Patel joined the industry in 2002 at AXA Advisors. After a brief stint at Morgan Stanley from September 2010 to June 2011, he moved to Wells Fargo in August 2011. He stayed until 2018, when he moved to Stifel. The firm fired him in January 2022 after he was “named in an indictment in United States District Court,” and FINRA barred him in May 2022.
According to the DOJ, about 48 people have pleaded guilty or been sentenced in connection with the plot.