Georgia ophthalmologist to pay $1.85M in fraudulent billing settlement

Atlanta-based ophthalmologist Aarti Pandya, MD, and the Pandya Practice Group have agreed to pay $1.85 million to resolve allegations that they violated the False Claims Act by billing the government for medically unnecessary procedures, according to a Jan. 9 report from the United States Attorney's Office. 

The settlement alleges that between 2011 and 2016, Dr. Pandya performed medically unnecessary cataract extraction surgeries and YAG laser capsulotomies and submitted the claims to federal healthcare programs. 

The attorney's office alleges that patients did not qualify for the procedures and, in some cases, faced long-term injury as a result of the surgeries. Documents also claim that Dr. Pandya incorrectly diagnosed patients with glaucoma to justify billing diagnostic testing to Medicare. 

The diagnostic tests were then improperly performed on broken machines. A former employee of the Pandya Practice, Laura Dildine, allegedly alerted the government to Dr. Pandya's wrongdoings under the whistleblower provision of the False Claims Act. 

Going forward, the practice will have to undergo an annual review of claims, documents and reimbursements. 

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