PATEL v. United States

CourtDistrict Court, D. New Jersey
DecidedDecember 22, 2022
Docket2:17-cv-07485
StatusUnknown

This text of PATEL v. United States (PATEL v. United States) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
PATEL v. United States, (D.N.J. 2022).

Opinion

NOT FOR PUBLICATION

UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY

: NITA PATEL, : : Civil Action No. 17-7485 (SDW) Petitioner, : : v. : OPINION : UNITED STATES OF AMERICA, : : Respondent. : :

APPEARANCES: CAROLINE CINQUANTO, Esq. Law Firm of Caroline Goldner Cinquanto 123 S. Broad Street, Suite 2500 Philadelphia, PA 19109

MARK E. CEDRONE, Esq. JESSE DAVID ABRAMS-MORLEY, Esq. Cedrone & Mancano, LLC 230 S. Broad Street, Suite 1100 Philadelphia, PA 19102 On behalf of Petitioner

NICOLE F. MASTROPIERI, Assistant United States Attorney United States Attorney's Office 970 Broad Street Newark, NJ 07102 On behalf of Respondent

WIGENTON, District Judge Presently before the Court is Petitioner Nita Patel’s ("Ms. Patel") amended motion to vacate sentence under 28 U.S.C. § 2255, challenging her criminal conviction and sentence upon her guilty plea to health care fraud in violation of 18 U.S.C. §§ 1347 and 2, in Criminal Action No. 15-592.1 (ECF No. 4). Ms. Patel alleges her counsel provided ineffective assistance from pre-plea investigation throughout sentencing. The Government filed an answer to the amended § 2255 motion (ECF No. 27), and Ms. Patel filed a reply brief (ECF No. 53). Subsequently, Ms. Patel

filed a supplemental motion for hearing (ECF No. 54), and the Government did not respond. For the reasons set forth below, this Court will deny the amended § 2255 motion on the briefs pursuant to Federal Rule of Civil Procedure 78(b), and deny the supplemental motion for an evidentiary hearing. I. BACKGROUND Ms. Patel and her husband, Kirtish Patel ("Kirtish" or "Mr. Patel"), pled guilty to federal health care fraud involving Medicare and private insurers, through a scheme in which they forged physician signatures to create false diagnostic reports purportedly written by physicians who had read and interpreted the results, and by false pretenses claiming neurological diagnostic tests were supervised by a physician.2 (Crim. ECF No. 30 at 1). According to the stipulation in

1 Docket Entries in Criminal Action No. 15-592 are cited herein as ("Crim. ECF No."), and docket entries in this Civil Action, No. 17-7485, are cited herein as ("Civ. ECF No.")

2 "Medicare regulations require all diagnostic testing to be 'reasonable and necessary,' as defined under Medicare Part B. In order for diagnostic neurological testing to be 'reasonable and necessary,' it must be performed under the proper level of physician supervision." United States ex rel. Doe v. Heart Sol., PC, 923 F.3d 308, 311 (3d Cir. 2019) (citing 42 U.S.C. § 1395y(a)(1)(A), 42 C.F.R. § 410.32(b)(1); 42 C.F.R. § 411.15(k).) In her reply brief, Ms. Patel maintains that her counsel failed to advise her that private insurance companies are not governed by the Medicare regulation requiring supervision by a neurologist. Although this is not addressed in the record, this Court notes that medical diagnostic testing is also governed by New Jersey law:

medical screening or medical diagnostic testing (other than clinical laboratory testing), conducted primarily for persons not receiving medical treatment from the testing entity, is nevertheless deemed to be a medical service. Such a practice shall be owned and under the plea agreement, as a result of the health care offense, the Patels, through their companies, Biosound Medical Services, Inc. ("Biosound") and Heart Solution, PC ("Heart Solution"), were paid more than $4,386,133.75, with payments from Medicare accounting for $1,668,954.95 of the total amount. (Crim ECF No. 30 at 9).

A. The Information On November 17, 2015, Ms. Patel was charged by Information with defrauding Medicare and private insurers from in or about September 2006 through in or about June 2014, in Morris County, New Jersey, in violation of 18 U.S.C. §§ 1347 and 2.3 (Crim. ECF No. 26). The factual

the responsibility of one or more physicians each of whom holds a plenary license from the State Board of Medical Examiners. All such testing, irrespective of the stationary or mobile nature of the facility, shall be performed under the authority of a designated responsible physician who shall establish a protocol and a quality assurance program for the specific type of screening or study. Results of all such procedures shall be interpreted by a physician holding a plenary license in this State, and documented in a written report which is preserved by the physician as required by N.J.A.C. 13:35–6.5.

Allstate Ins. Co. v. Northfield Med. Ctr., P.C., No. MRS-L-3228-99, 2001 WL 34779104, at *15–16 (N.J. Super. Ct. Law Div. Apr. 27, 2001); see, e.g., Allstate Ins. Co. v. Schick, 328 N.J. Super. 611, 628, 746 A.2d 546, 556 (Law. Div. 1999) (denying summary judgment where evidence suggested physician agreements were a sham that falsely represented compliance with state regulations). Thus, private insurance companies in New Jersey have an expectation that diagnostic testing was performed in accordance with the law. Notwithstanding, Ms. Patel knowingly and voluntarily pled to the factual basis, as outlined on the record and under oath.

3 18 U.S.C. § 1347(a), (b) provides:

Whoever knowingly and willfully executes, or attempts to execute, a scheme or artifice--

(1) to defraud any health care benefit program; or allegations in the Information are summarized as follows. Ms. Patel owned the business Heart Solution, and her husband owned Biosound. The Patels jointly operated both businesses and neither of them was a physician. Both businesses offered mobile diagnostic testing services that were conducted on-site at a physician's office. Biosound was a Medicare-approved provider

since 1999, and Heart Solution was a Medicare-approved provider since 2011. Private insurance companies and Medicare reimbursed Biosound for the performance and interpretation of tests ordered by a patient's primary care physician for diagnosis and treatment including: 1) echocardiograms to diagnose heart conditions; 2) chest, abdominal and lower leg ultrasounds to detect blood clots and abdominal aortic aneurysms; and 3) carotid ultrasounds to detect the risk of stroke. To receive reimbursement for these services, Medicare required Biosound to have a licensed subspecialist physician on staff to supervise and interpret any test performed in a particular subspecialty. Biosound purported to comply by Kirtish Patel travelling

(2) to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program, in connection with the delivery of or payment for health care benefits, items, or services, shall be fined under this title or imprisoned not more than 10 years, or both.

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PATEL v. United States, Counsel Stack Legal Research, https://law.counselstack.com/opinion/patel-v-united-states-njd-2022.