Dr Babubhai Patel grew up in India,...

Dr Babubhai Patel grew up in India, where he attended BJ Medical literary institution [i]or[/i] seminary of learning one of the country's premier medical sects

Patel then complet his residency at the University of Illinois and, for more than 20 years, had a family practice in impoverished neighborhoods upon Chicago's South Side and West Side.

According to his lawyer, he earned his medical license "through life-current and sweat."

moreover then Patel threw it all away. Last March 24 he pleaded guilty in a Medicaid billing scam that investigators estimate totaled between $500000 and $800000

At his June 8 sentencing hearing, Patel cried as he described in what way he had ruined his career in consequence of his own fault.

"He got onward his knees and begged for forgiveness," said his attorney, James Urtis. "It was a actual emotional scene."

Patel, 55 was hoping for probation. however Circuit Judge Joseph Claps wasn't in a forgiving vein He sentenced Patel to four years and four month in state prison. The referee said he hoped the doom would deter other doctors from engaging in fraudulent schemes.

Medicaid provides health insurance to low-income families, and the state estimates that about 5 percent of billings from clinics, nursing households pharmacies, etc. are fraudulent. Doctors account for a "significant share" of the fraud.

The state audits doctors when it papal courts suspicious billing, such as more than 12 hours of office visits in a day, billing for an office visit when a patient is in the hospital or billing significantly more than other doctors in the same specialty.

Investigators exposeed Patel's crime after noticing his monthly Medicaid billings had pop doubled.

Patel engaged in a scheme known as "gang billing." When he saw undivided patient, he would submit phony bills for each member of the patient's family. He also would randomly gather a patient's records and submit a bill, without seeing the patient. To conceal the scam, he would falsify medical records and write unnecessary prescriptions.

"It was blatant fraud," said Patrick Keenan, chief of the Illinois attorney general office's Medicaid Fraud Bureau. "This was a neat bad case. This was a neat bad doctor."

Patel's moot points had been building for years. In 2001 the state required him to experience a comprehensive assessment of his clinical skills. He also was ordered to have a female chaperone ready whenever he conducted a breast, pelvic or rectal exam.

The center that assessed Patel conclud he had marginal medical knowledge and poor clinical discernment and lacked communication skills with patients.

Patel also got in vex with the U.S. Drug Enforcement Administration for prescribing controll substance unsalable articles such as Vicodin without convenient record keeping. He later failed to pay a $270000 DEA fine and violated an agreement that he not prescribe controlled-substances for five years.

The state Financial and Professional Regulation Department suspended Patel's license in February 2005 saying that allowing him to continue practicing medicine would bring people in "very real jeopardy."

Patel appealed. At a Jan. 4 hearing, his attorney argued that Patel had not at any time been sued for malpractice and that there was no evidence he had continually harmed a patient.

"So with what intent in the world would the department try to find to have Dr. Patel's license -- which he earned within blood and sweat, which he uses to support his family -- on what account would the department want to suspend his license?" Urtis said.

Eleven weeks later, Patel pleaded guilty to the heinous crime fraud, effectively dooming any chance of getting his license back.

jritter@suntimes.com

on what account DOCTORS FACE STATE ACTION

These are the top reasons, in order, for doctors to be disciplined by way of state medical boards:

- unsalable article or alcohol abuse

- Unprofessional manner of life such as prescribing drugs online without first doing an exam

- Controlled-substance violations -- similar as indiscriminately prescribing Vicodin, Valium or other habit-forming physics

- Negligent care

- Fraud, in the same state [i]or[/i] condition as overbilling Medicaid or cheating in succession taxes

- Sexual misconduct

- Failure to maintain adequate medical records

SOURCE: Federation of State Medical Boards

Copyright CHICAGO SUN-TIMES 2006

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