Eye Doctor Accused Of Fraudulently Billing Patients, Medicare

RYE, NY — An ophthalmologist with practices in Rye, Mount Kisco and Wappingers Falls was indicted Friday for healthcare fraud. According to Geoffrey S. Berman, U.S. Attorney for the Southern District of New York, Ameet Goyal, M.D., 56, of Rye, was accused of fraudulently billing patients, Medicare and private insurance programs millions of dollars, between 2010 and 2017, for complex eye surgeries that he had not actually performed.

Berman's office also filed a civil fraud complaint against Goyal and The Eye Associates, which owns his medical practice, for engaging in healthcare fraud for "upcoding" the procedures, exams and tests in billings submitted to Medicare and Medicaid.

Authorities said Goyal also 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.

"Thanks to our law enforcement partners, Goyal's conduct has come into focus," Berman said. "Ameet Goyal now faces criminal prosecution and civil sanctions for his conduct."

For example, authorities said the doctor would remove a small bump on an eyelid, but bill for something as complex as excising a tumor from the eye socket, the former taking 15 minutes and the latter, an hour or more.

Between January 2010 through March 2017, Goyal caused the practice to bill insurance programs and patients more than $8 million for the inflated procedures.

The practice received more than $3 million in payments for the claims, authorities said.

Goyal is charged with three counts: healthcare fraud, which carries a maximum sentence of 10 years in prison; wire fraud, which carries a maximum sentence of five years, and making false statements relating to health care matters, which carries a maximum sentence of five years.

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