Indian-American doctor pays $1,850,000 for performing unnecessary tests, surgeries

Aarti D. Pandya and her Pandya practice group violated the False Claims Act by also conducting and billing for tests that were incomplete or worthless value, and office visits that did not provide the claimed level of service.

“Physicians who perform procedures and tests without a legitimate medical need are putting profit before patients and subjecting those patients to unnecessary risk,” said U.S. Attorney Ryan K Buchanan in a statement released Monday.

“This settlement represents our firm’s commitment to ensuring that physicians are accountable for subjecting patients to unwarranted medical care and wasting taxpayer money,” Buchanan said.

From Jan. 1, 2011, to Dec. 31, 2016, Pandya knowingly filed false claims with federal health care programs 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 who were ineligible for the procedure by accepted standards of medical practice and in some cases injured her patients.

In addition, it accused Pandya of falsely diagnosing patients with glaucoma to justify unnecessary diagnostic tests and treatments billed to Medicare.

The prosecution also said that many of the 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 Department of Health and Human Services (HHS) imposed a payment suspension on the Pandya Practice Group in 2019, preventing 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 amount of the suspension to the government.

The settlement also lifts the payment suspension.

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

“We need to reassure patients and taxpayers that healthcare is dictated by clinical needs, not fiscal greed,” said Keri Farley, FBI Atlanta Special Agent in Charge. “This settlement should serve as a reminder that the FBI will not tolerate health care providers engaging in schemes that defraud the industry and endanger innocent patients.”

January 11, 2023 Other New York

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