Opinion ID: 2982513
Heading Depth: 4
Heading Rank: 1

Heading: Lokesh Tayal

Text: Defendant Lokesh Tayal, a pharmacist, contends that the government failed to produce evidence that he voluntarily joined and participated in the conspiracies to commit health care fraud and to distribute controlled substances with the knowledge and intent to further the objectives of the conspiracies. He claims there was no evidence that he took direction from Patel with regard to filling prescriptions and distributing medications illegally. He argues that the proof that he may have filled the VDA prescriptions is not sufficient to show that he knowingly joined with Patel and others to further the two conspiracies charged in the indictment. Tayal cannot succeed in his appeal because the evidence was sufficient to prove his involvement in both conspiracies. Arpit Patel, a pharmacy technician, told the jury that he worked with Tayal at Grand River Pharmacy for approximately three years. He observed Tayal regularly bill for expensive brand-name medications but not dispense them to patients, in order to generate a huge profit for the pharmacy. Arpit Patel knew that Tayal ordered medications from the drug supplier so that, if there were an insurance audit, the type and quantity of medications brought into stock would match the pharmacy billings. The medications that were not actually dispensed were held for a week to fifteen days and then returned to the supplier for credit. -20- Nos. 13-1164/1173/1182/1215/1216 United States v. Babubhai Patel, et al. Arpit Patel also testified that he delivered fraudulent VDA patient prescriptions to pharmacies controlled by Babubhai Patel, including the Grand River Pharmacy where Tayal worked as the pharmacist. He delivered two prescriptions for each patient. One prescribed two to three controlled medications; the other prescribed between three and six noncontrolled medications. Arpit Patel observed as Tayal created patient profiles in the computer system and billed for all of the prescriptions, but filled only the controlled medications. Tayal’s initials on pharmacy documents identified him as the filling pharmacist on VDA prescriptions. For some VDA prescriptions, Tayal chose which medications to bill for, actually billed for them, and then directed Arpit Patel to write the prescriptions for those medications on a presigned, blank prescription pad. Other evidence against Tayal included the activities of LaVar Carter, who worked as a patient recruiter. He paid $100 each to homeless or elderly people who possessed Medicare or Medicaid cards so that they would have a “doctor visit” with a VDA doctor. The doctor wrote each of these patients prescriptions for Xanax, Lortab, and codeine-infused cough syrup because those three medications were the most lucrative for Carter to sell illegally on the street. Carter faxed the patients’ identification cards and their Medicare or Medicaid cards to the pharmacy. Most of the prescriptions were filled by Tayal at Grand River Pharmacy. Carter loaded the patients in a van and took them to the pharmacy so they could sign the prescription sheets. Even though the controlled substances were billed to Medicare or Medicaid, Carter also paid Tayal $150 to $200 per patient for filling the controlled substance prescriptions. Because Carter usually took ten patients at a time to Grand River Pharmacy to pick up medications, he paid Tayal $1,500 to $2,000 per visit, and there were two visits per week. Carter made $3,500 to -21- Nos. 13-1164/1173/1182/1215/1216 United States v. Babubhai Patel, et al. $5,000 each week by selling on the street, at double the pharmacy price, most of the controlled substances Tayal dispensed. Pinakeen Patel, another pharmacist, filled in for Tayal on one occasion at Grand River Pharmacy. He noticed from the pharmacy records that Tayal billed for four medications but dispensed only three. When he asked about this practice, Tayal described it as “pushing the medication” so that the pharmacy could recover money for patient co-pays it did not receive. The fourth medication that Tayal added on to each billing was usually a psychiatric medication that cost $400 to $500. Anish Bhavsar, a pharmacist, testified that Babubhai Patel bribed a particular physician to write fraudulent prescriptions. The doctor sent the prescriptions to two of Patel’s pharmacies to be filled; one of them was Grand River Pharmacy, where Tayal worked as the pharmacist. Chetan Gujarathi, Babubhai Patel’s accounting and administrative assistant, testified that he assisted Babubhai Patel in returning to the supplier $40,000 worth of medications that Tayal billed but did not dispense at Grand River Pharmacy. Although wiretap monitors rarely intercepted communications involving Tayal, the government admitted into evidence at trial a conversation between Tayal and Babubhai Patel about an FBI raid on their associate, Marcus Jenkins, who owned a home health care business. Tayal told Patel that the FBI, the Inspector General, and the Detroit Police were there, and that all of the records were being taken but that no one had been arrested yet. After discussing fraud practices in the home health care business, Patel stated: “That’s the reason, pharmacy I love it, nobody can touch.” Tayal responded, “Yeah,” to which Patel replied, “Nothing can happen.” Through this evidence, the government sufficiently tied Tayal to the Patel conspiracies to commit health care fraud and illegal distribution of controlled substances so that the jury could -22- Nos. 13-1164/1173/1182/1215/1216 United States v. Babubhai Patel, et al. convict him of counts 1 and 15 beyond a reasonable doubt. Circumstantial evidence proved that Tayal joined the conspiracies, that he understood the goals and objectives of the conspiracies, and that he willingly facilitated those goals and objectives. See Salinas, 522 U.S. at 65. Tayal himself did not have to undertake all of the acts necessary for the crimes’ completion. See id. His conspiracy convictions must stand.