In August the 5th Circuit U.S. Court of Appeals upheld Dr. Mehmood Patel’s 2008 health care fraud conviction and in November declined to reconsider the case. The former cardiologist had been seeking to remain free while he asks the U.S. Supreme Court to review the case, but prosecutors who have been fighting that request got their way last week when the appeals court said he must begin serving the sentence. Patel is to report to prison Dec. 17.
In late 2008 a jury found that between February 2001 and January 2004, Patel defrauded Medicare, Medicaid, and private insurers by seeking reimbursement for “medically unnecessary” procedures. Prosecutors said he fraudulently billed the government and private insurers more than $2 million. The jury convicted the former cardiologist on 51 of 91 counts of health care fraud. The initial 91 counts involved 74 different patients.
Federal prosecutors said Patel’s actions caused complications and serious harm to some patients who were subjected to angiogram, angioplasty and stent procedures they did not need. They said the doctor lied to patients about their medical conditions, performing most of these unnecessary tests and procedures at Our Lady of Lourdes and Lafayette General Medical Center.
By far the busiest cardiologist in town, according to prosecutors, Patel did not slow down until after his clinic, Acadiana Cardiology, was searched by investigators who had been tipped off by a whistleblower. From 1999 - 2003, Patel was the second highest biller in the entire state of Louisiana, according to the court record. “... there was evidence that Patel abruptly changed course, evincing possible consciousness of guilt, after the government executed its search warrant,” the appeals court writes. “He ordered fewer procedures, revised existing patient medical findings, and cancelled already scheduled stentings.”
In his appeal, Patel challenged just about every aspect of the prosecution, from his indictment to his sentence. Among the arguments in his appeal, which the 5th Circuit said touched “nearly every stage of the proceedings in the district court,” was that the district court coerced the jury by invoking what’s known as the “Allen” charge. U.S. District Judge Tucker Melancon used the Allen charge when he asked the deadlocked jury to continue its deliberations. Often called the “dynamite charge” or “hammer charge,” the jury instruction is intended to prevent a hung jury and mistrial by encouraging jurors to make a decision of guilty or not guilty.
According to the appeals court 's August decision:
Trial began on September 17, 2008. It spanned three and a half months. The government had at least one expert testify about each of the 91 procedures. The case first went to the jury on December 17. On December 22, the court dismissed the jury foreperson and seated an alternate. The jury was instructed to “begin its deliberations anew.” Then, in the early afternoon of the fifth day of the new deliberations, the court received a jury note indicating a possible deadlock. The court directed the jurors to review their prior instructions concerning deliberations. Jurors sent a similar note two hours later. The court responded with the Fifth Circuit’s pattern Allen charge. On the sixth day, after seven more hours of deliberation, the jury returned a verdict. It convicted Dr. Patel on 51 counts of health care fraud and acquitted him on the other 40 counts.
When a jury indicates that it is deadlocked, district courts have broad discretion to invoke the Allen charge. “The district court was appropriately hesitant to administer the charge and did so only after reflection and care,” the appeals court writes. “We find no abuse of this broad discretion in the district court’s giving of the charge.” The judges also noted the significance of the jury returning a discriminating verdict by acquitting Patel on 40 of the indicted counts.
Patel was sentenced to the statutory maximum 120 months in prison on each count, to run concurrently, followed by three years supervised release. He was ordered to pay the maximum guidelines fine of $175,000, in addition to the costs of incarceration and supervision, as well as $387,511 in restitution and a $48,631 forfeiture. At the time of his conviction, the court estimated his net worth as $6.4 million.
In early 2008 Lafayette General Medical Center settled civil lawsuits brought by Patel’s former patients for $1.8 million. The year before, Our Lady of Lourdes, where Patel did most of his work, paid $7.4 million to settle similar suits. LGMC also paid the federal government $1.9 million to settle claims it defrauded Medicare, Medicaid and other federal and state health plans from 1999 to 2003 by billing them for medically unnecessary procedures performed by Patel. Lourdes settled with the feds in August 2007 for $3.8 million.
At least two whistleblowers went to officials with information on Patel, including Neil Kinn, a registered nurse doing contract work at Patel’s clinic, and another local cardiologist, Dr. Christopher Mallavarapu.
JUNE 19 Former Saint Steve Gleason, who is paralyzed by ALS, released a statement Tuesday in response to the Atlanta radio station's skit making fun of him and the disease, this Picayune post reports. What did he say? He said he'd accepted the apology of the DJs who did it, notes that at least the incident has got people talking about ALS, and asks anyone who is burning to take action about it to do so -- by helping him fight ALS.
JUNE 19 Blogger Ian McGibboney takes a look at the Gleason incident in this post. He makes a good argument about the difference between having free speech and being free from consequences for your speech (which none of us is). He also admits that many of us got upset before we listened to the skit -- but lets us know that the reality is far worse than we can imagine. It was the incredibly bad judgment, even more than the actual speech, that probably got those DJs fired, he opines.
JUNE 19 Washington Post blogger Aaron Blake writes about Sen. Guillory's switch to the GOP in this post. He writes what most political watchers in Louisiana know: Guillory was a Republican before he decided to run for the senate seat in a mostly-D St. Landry district, and has switched back now that he plans to run for Lt. Gov. in a mostly-R state. But how come Blake missed Guillory's appearance on a TLC pageant show? Now that is a video we'd like to see. (Again).
JUNE 19 Here's another Washington Post blog post about a Louisiana politician, and it's just plain scathing. Ezra Klein says Jindal's Politico post was "insulting" to the intelligence of voters, and adds that Jindal is personifying the "stupid" he's railed against, by being an "elite" who convinces GOP activists of "things that aren't true." Me-ow.
JUNE 19 Here's Gov. Jindal's post in Politico, in which he asks the GOP to get over losing to Obama (again) and stop "the bedwetting." (Uh, what?) He gives his Republican buddies what is probably a nerd's idea of a coach's motivational talk, which starts with a list of accomplishments that they can't seem to exploit and ending with an absurd description of liberals that sounds like a character treatment for a Fox "News" movie scripted by Gordon Liddy. Sure, he's preaching to the choir, but even the choir's not this gullible.
JUNE 19 Lamar Parmentel read Gov. Jindal's post on Politico, but thinks it was so dumb it probably was published in the wrong paper. This post by Lamar on the Daily Kingfish opines that possibly Jindal's post was destined for the Onion -- because the governor couldn't possibly be serious here. If you listen closely, you can hear the staff of the Kingfish giggling.
JUNE 19 Blogger Robert Mann posts from Turkey, a country he has visited several times in the past few years. Mann gives an interesting overview of the current political and societal climate of the country, which -- if you're living under a rock and don't know -- is experiencing protests and turmoil these days. Mann promises to post as much as he can during his trip, which should be fascinating reading.
JUNE 19 Blogger CB Forgotston says the legislature is keeping the vicious cycle going with its funding of new buildings for the community college/technical college system. Universities across the state need maintenance and improvement on existing buildings, and the solution is to build new buildings at other schools? By the time the bonds are paid off, those buildings will be falling down, too, CB says.
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