Medical Doctor Settles Civil Fraud Allegations in Adult Homes Investigation
Dr. Rajendra Bhayani to Pay Over $1.1 Million to Resolve Kickback and Fraudulent Billing Allegations
Dr. Rajendra Bhayani, an otolaryngologist, has agreed to pay the United States $1,109,000 to resolve civil allegations that he and his practice – New York Otolaryngology & Aesthetic Surgery, P.C. in Brooklyn and Queens – paid kickbacks and submitted false claims to federal healthcare programs for services provided to residents in adult homes in violation of the False Claims Act.
Richard P. Donoghue, United States Attorney for the Eastern District of New York, and William F. Sweeney Jr., Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI), announced the settlement.
“The disabled and elderly residents of adult homes are among the most vulnerable members of our society, and doctors who treat these residents as commodities by paying kickbacks so they can administer medically unnecessary services at taxpayer expense will be held accountable by this Office,” stated United States Attorney Donoghue. Mr. Donoghue expressed his grateful appreciation to the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), for their assistance with the case.
“Elderly citizens without the means to care for themselves should be given the best treatment possible by everyone involved in their care. Exposing them to unnecessary medical testing and services because they’re deemed an easy target is disgraceful behavior,” stated FBI Assistant Director-in-Charge Sweeney. “Putting one’s self interests above the welfare of others isn’t the way to do business, and in this case it came with a hefty penalty.”
Adult homes are privately owned residential facilities licensed by the State of New York to provide long-term care and supervision to adults with disabilities or mental illnesses. An investigation by the FBI revealed that from 2012 through 2016, Bhayani allegedly paid cash tips, excessive rent and other improper remuneration to medical management companies in adult homes in the Eastern District of New York to obtain exclusive access to bill for allergy testing and other medical services to residents in violation of the Anti-Kickback Statute. Bhayani then obtained payment for these services from Medicare and the Federal Employees’ Health Benefits Program, although the services were actually performed by his nurse practitioner, and some of the services performed were medically unnecessary.
HHS-OIG has concurrently entered into an Integrity Agreement with Bhayani and New York Otolaryngology & Aesthetic Surgery, P.C. Among other things, the Integrity Agreement requires compliance training that specifically addresses the Anti-Kickback Statute and a quarterly claims review to be conducted by an Independent Review Organization.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
The government’s case is being handled by Assistant United States Attorney Lisa Kutlin of the Office’s Civil Division.