Indian-origin US doctor fined $2M for false surgery billing fraud

A 63-year-old Indian-origin pain medicine doctor based in Houston, Texas, has agreed to pay more than $2 million (approximately Rs 17.4 crore) to settle allegations of healthcare fraud, according to the US authorities.

Dr Ajay Aggarwal agreed to pay $2,053,515 to resolve claims that he submitted false billing to Medicare and to the Department of Labor's Workers' Compensation Programs between November 2021 and March 2023, for surgical procedures that were never actually performed.

Aggarwal is an anesthesiologist and pain medicine doctor who also practices in Texas' Bellaire city, Lake Jackson city and Van Vleck (in Matagorda County). He runs his medical practice, called The Pain Relief & Wellness Center, through his own business and a company named PRWCSWTX LLC, according to the statement issued on Monday (August 11) by the US Attorney's Office, Southern District of Texas.

Aggarwal billed federally funded healthcare programmes for the surgical implantation of neurostimulator electrodes, according to the statement. These are invasive procedures usually requiring use of an operating room. As a result, Medicare and other federally funded healthcare programmes pay thousands of dollars per procedure, the statement added.

However, neither Aggarwal nor his staff performed these surgical procedures, according to the allegations, the statement further said.

However, investigators said Aggarwal instead used electro-acupuncture devices on his patients, which involved inserting thin wires into the ear and taping a small neurostimulator behind the ear – none of which required surgery or incisions.

All treatments were done at Aggarwal's clinic, not a hospital or surgical centre, and no incision was made on a patient, according to the allegations.

ATTORNEY VOWS TO RECOVER LOSSES FROM FRAUDULENT MEDICARE BILLING

US attorney Nicholas J Ganjei slammed the "fraudulent billing" by the doctor and vowed to recover the losses.

"A doctor who uses simple medical devices on his patients, yet bills Medicare for a sophisticated spinal surgery, is bilking the American taxpayer, plain and simple," said Ganjei.

"The Southern District of Texas will ensure that losses to federally funded healthcare programs from fraudulent billing, like what happened here, are recouped and that wrongdoers are held accountable," the attorney added.

Last month, a doctor of Indian-origin admitted guilt to federal charges related to illegally prescribing strong opioids, resulting in the overdose deaths of two patients.

As part of his plea, Sanjay Mehta admitted to writing unjustified prescriptions for oxycodone, methadone, and Roxicodone (a branded form of oxycodone hydrochloride) to three different patients in Virginia.

"Two of the three customers died of opioid intoxication within days of receiving their unlawful prescriptions," US Attorney's Office said in a statement.

The quantum of Mehta's punishment will be announced on October 31.

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