Dr. Payam Toobian – The Medicaid Fraudster with Illegal Kickbacks?
A Long Island doctor has been charged with paying kickbacks to physicians in exchange for patient referrals and defrauding Medicaid by completing superfluous medical exams.
Who is exactly Dr. Payam Toobian?
Dr. Payam Toobian claims to be a well-known medical doctor and neurosurgery specialist in New York State. Throughout his career, Dr. Payam Toobian has claimed on his official website that he has helped thousands of patients gain access to life-saving medical tests and operations. Bragging about his work and research in spinal syringomyelia, Dr. Payam Toobian shows off as inspirational but also shows off about himself being helpful as Dr. Payam Toobian claims that he has helped to develop novel treatment options for the illness.
Dr. Payam Toobian Kickback’s conspiracy
Dr. Payam Toobian, M.D. aged 52, of Kings Point, who owns America’s Imaging Center, Inc., is charged with several felonies, including third-degree grand larceny and health care fraud, eight counts of falsifying business records in the first degree, and three counts of violating the Social Services Law statute that prohibits the payment of kickbacks related to Medicaid program services.
Dr. Payam Toobian is accused of orchestrating a multi-year bribery operation in which Dr. Payam Toobian bribed doctors for patient referrals. Dr. Payam Toobian allegedly performed medically unnecessary testing and submitted fake Medicaid claims.
Illegal and unethical actions are included in Medicare and Medicaid fraud to receive payments funded by government healthcare programs.
According to prosecutors, the tests included MRIs of the head, cervical spine, and lumbar spine, all “with contrast,” which prompted patients to receive unneeded and intrusive injections.
Prosecutors claim that from January 2006 to August 2017, Dr. Payam Toobian allegedly gave gift cards, cash, and checks totaling more than $547,000 to three doctors in exchange for patient referrals to Empire Imaging, a diagnostic radiology center in Forest Hills, N.Y. that Dr. Payam Toobian ran through America’s Imaging Center. Empire Imaging allegedly collected more than $1 million in paid referral claims.
In addition to the kickback scheme, the surgeon allegedly told Empire Imaging employees from January 2014 to August 2017 to add “additional, unordered radiological procedures to orders submitted by referring physicians to increase the amount of money Empire Imaging would receive from Medicaid,” according to prosecutors.
Dr. Payam Toobian’s charges include grand larceny, healthcare fraud, fabricating business documents, and breaching the Social Services Law provision barring the payment of kickbacks for services provided under the state’s Medicaid program.
What Attorney General James Said on Payam Toobian Kickback Conspiracy
Dr. Payam Toobian, M.D. of Kings Point, New York, and his organization, America’s Imaging Center, Inc. (America’s Imaging), were charged today by New York Attorney General Letitia James with cheating Medicaid by forcing patients to undergo unneeded and invasive medical tests.
What attorney James further mentions is that Dr. Payam Toobian allegedly conducted a kickback scheme for years, bribing other physicians for patient referrals, subjecting some of those patients to unnecessary tests and procedures, and then submitting false claims to Medicaid for those tests.
Dr. Payam Toobian ran Empire Imaging, a diagnostic radiology center in Forest Hills, Queens, through his company America’s Imaging. Dr. Payam Toobian was charged with Grand Larceny in the Third Degree, Health Care Fraud in the Third Degree, eight counts of Falsifying Business Records in the First Degree, and three counts of violating the Social Services Law statute prohibiting the payment of kickbacks related to the provision of Medicaid services, all of which are felonies.
Words by James- “New Yorkers should be able to trust that their doctors are working to heal them, not profit off of their suffering”. “Bribery and kickback schemes corrupt our healthcare system and make it impossible for patients to receive the care that they need. The idea that a licensed physician would subject patients to unnecessary testing to line their pockets is unconscionable, and my office will continue to go after medical providers that jeopardize the health and safety of New Yorkers.”
In a separate civil lawsuit filed in the United States District Court for the Eastern District of New York, the Office of the Attorney General (OAG) is also seeking damages from Payam Toobian and America’s Imaging, among other defendants, for violations of the Federal and New York State False Claims Acts, as well as other civil causes of action.
The OAG wishes to thank the U.S. Department of Health and Human Services, Office of Inspector General, New York State Department of Health, Medicaid MCOs, HealthFirst, MetroPlusHealth, and United Healthcare, for their cooperation and invaluable support during the inquiry.
Detectives Thomas Bolen, Robert Hatt, Dawn Scandaliato, and Michael McNally headed the MFCU investigation, with support from Supervising Detective Ronald Lynch, Deputy Chief Kenneth Morgan, and Deputy Chief William Falk. Senior Auditor-Investigator Deowattie Persaud and Auditor-Investigator Khristian Diaz did the underlying financial analysis, with help from Regional Chief Auditor Stacey Millis.
Special Assistant Attorneys General Peter Zadek and Robert Trudell are prosecuting the criminal case under the supervision of Thom O’Hanlon, Chief of MFCU Criminal Investigations-Downstate. Special Assistant Attorney General Jared Goldman is handling the civil case, with help from Konrad Payne, Deputy Chief of the MFCU Civil Enforcement Division, and MFCU Civil Enforcement Division Chief Alee Scott. Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney lead the MFCU. Chief Deputy Attorney General José Maldonado leads the Division for Criminal Justice, which is managed by First Deputy Attorney General Jennifer Levy.
In this scenario, the charges are only accusations. Unless and until found guilty in a court of law, the defendants are deemed innocent.
What is exactly Kickback in Medical Terms (Dr. Payam Toobian’s Crime)
A kickback is an illegal payment made in exchange for preferential treatment or other types of illicit services. The kickback could be cash, a gift, credit, or anything else of value. Paying or receiving kickbacks is corrupt conduct that impairs the ability of an employee or public official to make unbiased decisions. Kickbacks are frequently referred to as a kind of bribery.
- A kickback is an illegal payment made in exchange for preferential treatment or other types of illicit services.
- Kickbacks are frequently referred to as a kind of bribery.
- While there are many distinct types of kickbacks, they all include some sort of collaboration between two parties.
- Paying or receiving kickbacks is corrupt conduct that impairs the ability of an employee or public official to make unbiased decisions.
It’s easy to define kickbacks in health care. A kickback occurs when a physician or medical practitioner utilizes any payment or remuneration to urge a patient to visit their office or facility, or to encourage another medical professional to refer patients to their office or facility.
Physicians and other medical practitioners are not permitted to persuade or coerce recommendations for federally funded medical care. This prohibition applies to Medicare and Medicaid participants, as well as any other federally funded health program.
Penalties for Anti-Kickback Statute (AKS) violations are severe and costly.
The penalties apply not only to the medical practitioner who pays bribes in health care but also to the medical provider who receives those kickbacks – and they apply to each kickback.
Violations, according to the Office of Inspector General (OIG), can result in both criminal and administrative penalties. Fines, jail time, and disqualification from Medicare, Medicaid, and other federal health programs are among them.
Each infraction can result in a punishment of up to $50,000, plus three times the amount of the kickback.
In addition to monetary penalties, violators may face up to five years in prison.
Conclusion
A physician named Dr. Payam Toobian who owns an imaging facility has been charged with filing false claims with CMS and enticing others to arrange unnecessary tests. Among these tests were some that required IV contrast.
The claims were made public by New York Attorney General Letitia James. According to her office, Dr. Payam Toobian, MD, a 51-year-old neurosurgeon, reportedly ran a kickback scam “for years” out of Empire Imaging in Queens. The center was run by Dr. Payam Toobian’s company, America’s Imaging, according to the announcement.
According to James, Empire Imaging earned more than $1 million through business claims. Among the needless imaging examinations that put patients in danger were contrast-enhanced MRIs of the brain, lumbar spine, and cervical spine.
Dr. Payam Toobian is accused of grand theft, healthcare fraud, tampering with company data, and violating a Medicaid anti-kickback law, among other things. Each of these allegations is criminal, according to the office.
