These cases are the easy ones. You need to throw lots more investigative bodies at the problem. Itβs that voluminous. The ICD-10 manual was expanded a few years ago and added almost 100k extra medical codings. Confusing? Yep. They data mine trying to find the easy ones.
Dr. Jitesh Patel & Advanced Urology in Georgia:
In April 2026, the Department of Justice announced a massive $14 million False Claims Act settlement involving an Indian American urologist, Dr. Jitesh Patel, and his practice group, Advanced Urology.
Federal investigators alleged that Dr. Patel and his practice systematically subjected patients to medically unnecessary procedures and diagnostic tests. These unnecessary actions were performed for the explicit purpose of artificially inflating revenue and upcoding claims submitted to Medicare and Medicaid.
Whistleblowers came forward and shared valuable information and documentation to support their case that Dr Patel was filing fraudulent claims & performing unnecessary procedures just to maximize his profits.
Under the False Claims Act, the whistleblowers are entitled to a share in the recovery funds collected by the government.