Georgia doctor reaches $1.8M settlement over medically unnecessary eye surgeries

A Conyers doctor will pay the government over $1.8 million to resolve allegations that they billed the government for cataract surgeries and tests that were not necessary or incomplete.

The United States Attorney for the Northern District of Georgia says that Aarti D. Pandya, M.D. submitted false claims to federal healthcare programs for medically unnecessary cataract extraction surgeries and YAG laser capsulotomies.  

According to officials and court documents, Pandya performed the procedure for patients who did not qualify for the procedure and in some cases even injured them during the procedure.

The government also alleges that the doctor falsely diagnosed patients with glaucoma so that she could charge the government for diagnostic testing and treatments billed to Medicare.

"Physicians who perform procedures and tests without a legitimate medical need place profits ahead of patients and subject those patients to unnecessary risk," said U.S. Attorney Ryan K. Buchanan "This settlement represents our office’s commitment to ensuring accountability for physicians who subject patients to unwarranted medical care and waste taxpayer funds." 

A whistleblower and former employee at the Pandya Practice Group sued the clinic under the False Claims Act, which allows private parties to sue on behalf of the United States. The government intervened in 2018 and suspended the practice group from receiving any reimbursements from Medicare for Part B claims. As part of the settlement, the payment suspension will be lifted.

"We must assure patients and taxpayers that healthcare is dictated by clinical needs, not fiscal greed," said Keri Farley, Special Agent in Charge of FBI Atlanta. "This settlement should serve as a reminder that the FBI will not tolerate healthcare providers who engage in schemes that defraud the industry and put innocent patients at risk."

As part of the settlement, the group will pay around $1.85 million.