STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF MEDICINE, )

)

Petitioner, )

vs. ) CASE NO. 88-4786

)

PRAVINKUMAR PATEL, M.D., )

)

Respondent. )

)

RECOMMENDED ORDER

This matter was heard by William R. Dorsey, Jr., the Hearing Officer designated by the Division of Administrative Hearings, on December 14, 1989, in Fort Lauderdale, Florida.

APPEARANCES

For Petitioner: Joseph Harrison, Senior Attorney

Department of Professional Regulation

1940 North Monroe Street Tallahassee, Florida 32399-0750

For Respondent: No Appearance

STATEMENT OF THE ISSUES

Whether disciplinary action should be taken against Respondent's license to practice medicine for filing false and fraudulent insurance claims and failing to make records available to patients.

PRELIMINARY STATEMENT

Although provided due notice, Dr. Patel failed to appear for the final hearing. The Depariment filed a proposed recommended order, which has been incorporated in this order.

FINDINGS OF FACT

1. Respondent is, and has been at all times material hereto, a licensed physician in the State of Florida. He holds license number ME 0039675.

   
   

2. Respondent repeatedly filed false and fraudulent insurance claim forms on patients C.J., his wife K.J. and their children which were paid. These included claims for removal of benign lesions, a proctosigmoidoscopy and related treatment, and surgery on a perianal abscess on C.J. who never saw Dr. Patel, or any physician, for such treatment or care. False claims for care for office visits, x-rays, blood work and stress tests for K.J. were submitted. False claims for care never provided to the children were also concocted. He received

   payment for services and procedures that were never performed or even attempted, and to support the fraudulent insurance claims, Dr. Patel even created false operative reports.

   
   

3. Dr. Patel wrongfully fai1ed to release patient records to C.J. and his family, when required by law to do so. The continuing nature of the false billing leads to the inference that the records were withheld in an attempt to cover up Dr. Patel`s wrongdoing.

   
   

   CONCLUSIONS OF LAW

   
   

4. The Division of Administrative Hearings has jurisdiction over this matter. See Sections 120.57(1) and Section 455.225, Florida Statutes (1985).

   
   

5. Pursuant to Section 458.331(2), Florida Statutes (1985), the Board of Medicine is empowered to revoke, suspend or otherwise discipline the license of a physician for any of the following violations of Section 458.331(1), Florida Statutes (1985):

   
   

6. Section 458.331(1)(h): Failing to perform a legal obligation, by failing to furnish patient medical records on request, as required by Section 455.241(1), Florida Statutes (1985);

   
   

7. Section 458.331(1)(i): Filing a false or fraudulent report;

   
   

8. Section 458.331(1)(1): Making deceptive untrue and fraudulent representations in the practice of medicine.

   
   

9. Petitioner proved by clear and convincing evidence that Dr. Patel repeatedly violated these statutes.

RECOMMENDATION

It is RECOMMENDED that the Respondent be found guilty of violating Sections 458.331(1)(h)(i) and (1) , Florida Statutes (1985). Due to Dr. Patel's clear and repeated pattern of fraud and deceptive practices in his medical practice, his license to practice medicine should be revoked.

DONE AND ENTERED in Tallahassee, Leon County, Florida, this 28th day,of December, 1989.

WILLIAM R. DORSEY,

Hearing Officer

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-1550

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings this 28th day of December, 1989.

COPIES FURNISHED:

Joseph Harrison, Senior Attorney Department of Professional Regulation 1940 North Monroe Street

Tallahassee, Florida 32399-0750

Pravinkumar Patel, M.D. Post Office Box 9828

Coral Springs, Florida 33075

Kenneth D. Easley, General Counsel Department of Professional Regulation 1940 North Monroe Street

Tallahassee, Florida 32399-0750

Dorothy Faircloth, Executive Director Department of Professional Regulation Board of Medicine

1940 North Monroe Street Tallahassee, Florida 32399-0750

Docket for Case No: 88-004786

Orders for Case No: 88-004786