Hudson Valley Doctor Accused of Stealing Millions From Patients
A doctor who had multiple practices in the Hudson Valley and Connecticut is accused of stealing millions from patients.
On Friday, Ameet Goyal, an eye doctor with practices in Wappinger Falls, Rye, Mt. Kisco and Connecticut was indicted for healthcare fraud. The 56-year-old from Rye owns and operates The Eye Associates Group, officials say. A civil fraud complaint was filed against Goyal and his practice, under the False Claims Act.
According to the indictment, Goyal fraudulently billed patients, Medicare and private insurance programs millions of dollars, between 2010 and 2017, for complex eye surgeries that Goyal never performed. The civil complaint further alleges that the doctor and his medical practice engaged in widespread healthcare fraud by consistently “upcoding” these and other surgical procedures, examinations, and tests in fraudulent billings submitted to Medicare and Medicaid.
Between about January 2010 through about March 2017, Goyal caused his practice to bill insurance programs and patients over $8 million for supposedly performed orbitotomies, bundled conjunctivoplasties and excisions and repair of the eyelid, officials say. The practice received over $3 million in payments for these claims, a substantial portion of which were fraudulently billed, according to the indictment.
“As alleged, Dr. Ameet Goyal repeatedly upcoded minor ophthalmological procedures, defrauding insurers and patients by grossly overbilling, netting millions in ill-gotten gains in the process. As further alleged, Goyal also billed for tests and procedures that were never performed, falsified medical records, bullied others in his practice to abet the scheme, and intimidated patients who questioned their bills. Thanks to our law enforcement partners, Goyal’s conduct has come into focus. Ameet Goyal now faces criminal prosecution and civil sanctions for his conduct," U.S. Attorney Geoffrey S. Berman said.
Goyal also allegedly falsified patient medical records, pressured other employees in his practice to engage in the scheme and initiated debt collection proceedings against patients who did not pay the full amounts of his fraudulently billed charges.
“When we go to the doctor, we have to put our faith in their knowledge because they have expertise we don’t. Dr. Goyal allegedly lied to patients about what they were being billed for, forced them to pay for treatments they didn’t receive, and then threatened his staff if they expressed alarm about taking part in the fraud," FBI Assistant Director William F. Sweeney Jr. said. "Medical practitioners who are more concerned with their profits than with the health of their patients are going against the oath they took, they are doing harm and they should be held accountable.”
Goyal was arrested Friday morning and charged with healthcare fraud, wire fraud and making false statements relating to health care.
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