Ameet Goyal, an ophthalmologist with offices in Fairfield, Westchester and Dutchess Counties, was sentenced to 96 months in prison for conducting a seven-year health care fraud scheme that falsely billed for millions of dollars of upcoded procedures and for fraudulently obtaining two pandemic-era government-guaranteed loans.
Goyal owned and operated ophthalmology practices in Greenwich, Mount Kisco, Rye and Wappingers Falls. According to the charges brought against him, he consistently upcoded 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. As a result of these practices, he fraudulently obtained at least $3.6 million in payments for procedures he did not perform, and he became the highest-billing doctor in the tri-state area for several of his fraudulently billed codes ”“ including one of which he billed seven times more frequently than all doctors in the tri-state area combined.
Goyal was indicted for the healthcare fraud charges in November 2019 and was released on bail. However, at the start of the pandemic Goyal applied to the Small Business Administration and Bank-1 for over $630,000 in government-guaranteed loans through the Paycheck Protection Program. On his loan applications, he falsely answered that he was not facing any pending criminal charges and falsely certified that his business would not receive another PPP loan until the end of the year.
After obtaining the loans, he used the funds to pay business and personal expenses, including payments to a Westchester country club, a California vineyard and a golf merchandise website.
Goyal, who previously pled guilty to all charges in a six-count superseding indictment last September, was also sentenced to 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.
It never ceases to amaze me the greed, acts of fraud and theft people are willing to do to support their lavish lifestyles. Humility starts with living within your means. No sympathy, I think his sentence is well-justified.