Ameet Goyal, a Rye ophthalmologist, Sentenced to 96 Months for Healthcare Fraud and Covid-19 Loan Fraud

In a shocking display of greed, Ameet Goyal, an ophthalmologist in Rye, New York, has been sentenced to 96 months in prison for orchestrating a seven-year healthcare fraud scheme and fraudulently obtaining two Government-guaranteed loans intended to help small businesses during the COVID-19 pandemic.

Goyal, who owned and operated the ophthalmology practice Ameet Goyal M.D. P.C., doing business as Rye Eye Associates, with offices in Rye, Mt. Kisco, and Wappingers Falls, New York, and Greenwich, Connecticut, engaged in widespread healthcare fraud by consistently ‘upcoding’ simpler, lower-paying surgical procedures and examinations as complex, higher-paying major operations in fraudulent billings submitted to Medicare, private insurance companies, and patients.

Between 2010 and 2017, Goyal fraudulently obtained at least $3.6 million in payments for procedures he did not perform. He failed to obtain proper and, at times, any consent for the upcoded procedures he falsely claimed to have performed. As part of the scheme, Goyal routinely falsified patient medical records, authoring fictitious templated operative reports that matched the complex operation he billed rather than the different minor procedure he actually performed.

Goyal also pressured other employees in his Practice to engage in the scheme, and threatened the livelihood of employees who refused to comply. He caused patients to pay thousands of dollars out of pocket for fraudulently billed charges, and initiated debt collection proceedings against patients who did not pay the full amounts of those false charges.

In addition to the prison term, Goyal was sentenced today to five years of supervised release, and ordered to pay forfeiture of $3.6 million and restitution of $3.6 million. Goyal has already paid approximately $1.79 million toward these obligations.

U.S. Attorney Damian Williams said: ‘A prominent ophthalmologist and oculoplastic surgeon who has now surrendered his medical license, Ameet Goyal was blinded by greed. Over a seven-year period, he preyed on the trust placed in him and cheated patients and insurance companies of $3.6 million in false charges.’

As part of the scheme, Goyal was indicted for the healthcare fraud charges in November 2019 and was released on bail. The Coronavirus Aid, Relief, and Economic Security (CARES) Act, a $2.2 trillion economic stimulus bill passed in March 2020, provided small businesses with low-interest loans to help them stay afloat during the pandemic. Goyal fraudulently obtained two Government-guaranteed loans intended to help small businesses during the COVID-19 pandemic while he was facing charges on pretrial release for the healthcare fraud scheme.

Goyal will serve a substantial sentence in prison for his crimes, including a 96-month prison term, five years of supervised release, and ordered to pay forfeiture of $3.6 million and restitution of $3.6 million. He has already paid approximately $1.79 million toward these obligations.

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