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An Indian-born doctor and her medical practice group will pay $1.85 million to resolve allegations that she and her medical practice group billed the government for cataract surgeries and diagnostic tests that were not not medically necessary and office visits that did not provide the level of benefit claimed.
New York, UPDATED: Jan 12, 2023 11:04 IST
An Indian-born doctor will pay $1.85 million to resolve allegations of government billing for medically unnecessary cataract surgeries and diagnostic tests. (Representative image)
By Press Trust of India: An Indian-born doctor and his medical practice group will pay $1.85 million to resolve allegations that they billed the government for medically unnecessary cataract surgeries and diagnostic tests that, in some cases, even caused injury to his patients.
Aarti Pandya and Aarti D. Pandya, MD PC have agreed to pay approximately $1,850,000 to resolve allegations that they violated the False Claims Act.
Federal prosecutors allege that Pandya and her medical practice billed the government for cataract surgeries and diagnostic tests that were not medically necessary, incomplete or worthless, and for office visits that did not provide the level of service requested.
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Doctors who perform procedures and tests without a legitimate medical need are putting profits ahead of patients and exposing those patients to unnecessary risk, U.S. Attorney Ryan Buchanan said in a statement Monday.
Authorities said the settlement resolves allegations that, from Jan. 1, 2011, to Dec. 31, 2016, Pandya knowingly submitted false claims to federal health programs for medically unnecessary cataract removal surgeries and other procedures. .
The government alleges that Pandya performed these procedures on patients who were not eligible for them according to accepted standards of medical practice and, in some cases, caused injuries to his patients.
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Additionally, the government alleged that Pandya misdiagnosed patients with glaucoma to justify unnecessary diagnostic tests and treatments billed to the government’s Medicare health insurance program.
Many diagnostic tests ordered by Pandya were not performed properly, were performed on a broken machine, or were not interpreted in the medical record as required by Medicare.
The $1.85 million settlement resolves allegations in a lawsuit filed in the Northern District of Georgia by Laura Dildine, a former employee of the Pandya Practice Group, under the whistleblower provisions of the False Claims Act (FCA).
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The FCA allows private parties to sue for misrepresentation on behalf of the United States and share in the recovery.
FBI Atlanta Special Agent in Charge Keri Farley said the settlement should be a reminder that authorities will not tolerate health care providers who engage in schemes that defraud the industry and put innocent patients at risk .
We must assure patients and taxpayers that health care is driven by clinical need, not fiscal greed, Farley said.
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Posted on:
January 12, 2023
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