Indian-American doctor asked to pay $1,850,000 for performing unnecessary tests, surgeries

Indian-American doctor asked to pay $1,850,000 for performing unnecessary tests, surgeries

The prosecution also said that many of the diagnostic tests that the doctor ordered were not properly performed, were performed on a broken machine, or were not interpreted in the medical record, as required by Medicare.

FPJ Web DeskUpdated: Wednesday, January 11, 2023, 06:55 PM IST
article-image
Indian-American doc asked to pay $1,850,000 for performing unnecessary tests, surgeries | Representational image/ Pixabay

New York: Punitive action in the form of fines have been taken against an Indian-American doctor for allegedly billing the government for cataract surgeries and diagnostic tests that were not medically required. The doctor has agreed to pay approximately $1,850,000.

The doctor, identified as Aarti D. Pandya and her Pandya Practice Group violated the False Claims Act by also performing and billing for tests that were incomplete or of worthless value, and office visits that did not provide the level of service claimed.

Frauds date back to 2011

"Physicians who perform procedures and tests without a legitimate medical need place profits ahead of patients and subject those patients to unnecessary risk," said US Attorney Ryan K Buchanan in a statement released on Monday. 

"This settlement represents our office's commitment to ensuring accountability for physicians who subject patients to unwarranted medical care and waste taxpayer funds," Buchanan said.

From January 1, 2011 to December 31, 2016, Pandya knowingly submitted false claims to federal healthcare programmes for medically unnecessary cataract extraction surgeries and YAG laser capsulotomies, according to a Justice Department release. 

The prosecution alleged that Pandya performed these procedures on patients that did not qualify for the procedure under accepted standards of medical practice and, in some cases, caused injury to her patients. 

Additionally, it accused Pandya of falsely diagnosing patients with glaucoma to justify unnecessary diagnostic testing and treatment that was billed to Medicare. 

The prosecution also said that many of the diagnostic tests that Pandya ordered were not properly performed, were performed on a broken machine, or were not interpreted in the medical record, as required by Medicare.

Payment suspension on the Pandya Practice Group

The Department of Health and Human Services (HHS) imposed in 2019 a payment suspension on the Pandya Practice Group that precluded it from receiving any reimbursement from Medicare for Part B claims.

As part of the settlement of the government's claims in this case, the Pandya Practice Group agreed to forfeit the suspension amount to the government. 

The payment suspension will also be lifted as part of the settlement.

To protect federal healthcare programmes and beneficiaries going forward, Pandya and the Pandya Practice Group have entered into a detailed, multi-year Integrity Agreement and Conditional Exclusion Release (IA) with the Office of Inspector General.

"We must assure patients and taxpayers that healthcare is dictated by clinical needs, not fiscal greed," said Keri Farley, Special Agent in Charge of FBI Atlanta. "This settlement should serve as a reminder that the FBI will not tolerate healthcare providers who engage in schemes that defraud the industry and put innocent patients at risk."

(with agency inputs)

RECENT STORIES

From Pyongyang To Beijing: The Emergence Of The 'Putin Pact' Raises Global Concerns

From Pyongyang To Beijing: The Emergence Of The 'Putin Pact' Raises Global Concerns

'From No Fly List To Tribute': Canadian FM Stumped By Question On Hardeep Singh Nijjar; VIDEO

'From No Fly List To Tribute': Canadian FM Stumped By Question On Hardeep Singh Nijjar; VIDEO

Explained: Strategic Partnership Treaty Signed Between North Korea & Russia; How It May Impact The...

Explained: Strategic Partnership Treaty Signed Between North Korea & Russia; How It May Impact The...

Pakistan Horror: Man Burnt Alive By Mob For Desecrating Quran, Police Station Torched In Swat...

Pakistan Horror: Man Burnt Alive By Mob For Desecrating Quran, Police Station Torched In Swat...

Tajikistan: Upper Chamber Of Parliament Passes Law Banning Hijab & Public Celebrations Of Eid

Tajikistan: Upper Chamber Of Parliament Passes Law Banning Hijab & Public Celebrations Of Eid