Doctor Pleads Guilty to Multi-Million Dollar Fraud That Included Suing Patients With Unpaid Debts

It’s one thing to defraud healthcare insurers and Medicaid for millions of dollars, and to “loot” hundreds of thousands of dollars from banks under the Paycheck Protection Program, but did the guy have to initiate debt collection proceedings against the patients he was bilking, too? In for a penny, in for a pound, I guess, was the motto of Ameet Goyal, an ophthalmologist in New York, who pleaded guilty to healthcare and wire fraud and is now facing a very long prison term.

Goyal pleaded guilty this week to a scam in which he upcoded low-cost procedures into complex, higher-cost operations, billing patients and insurers for the more expensive procedures. Prosecutors alleged that Goyal reaped at least $3.6 million in payments for procedures he did not perform. Patients of the good doctor were forced to pay thousands of dollars out of their own pockets for these fraudulently billed charges, and had debt collection proceedings initiated against them if they did not pay what he was demanding.

Goyal also applied for two loans under the PPP, totaling $630,000, while he was facing charges of defrauding patients and insurers. He used the same underlying documentation for each loan, changing the name of the business and email contact information to make it appear as though the businesses were separate.

Under terms of the guilty plea, Goyal is facing between 151 and 188 months in prison. He has also agreed to forfeit the $3.6 million in ill-gotten gains and has already repaid the money loaned to him under the Paycheck Protection Program. He is scheduled to be sentenced on January 6.

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