(STL.News) – Ghanshyam Bhambhani, a former Queens cardiologist, will pay a total of $2 million to settle civil claims that he paid kickbacks to other physicians for referrals of patients insured by Medicare, Medicaid and the Federal Employees’ Health Benefits Program. Under the terms of the settlement, Bhambhani will pay the United States $1,370,294.50. In addition, he will pay the State of New York $629,705.50.
Seth D. DuCharme, Acting United States Attorney for the Eastern District of New York, William F. Sweeney Jr., Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI), and Norbert E. Vint, Deputy Inspector General Performing the Duties of the Inspector General for the Office of Personnel Management (OPM-OIG), announced the settlement.
An investigation by the Office, the FBI and OPM-OIG revealed that, from 2010 through 2017, Bhambhani paid other doctors compensation disguised as rent for patient referrals in violation of the Anti-Kickback Statute and the False Claims Act. The investigation also revealed that Bhambhani falsified records to justify cardiac procedures. Bhambhani admitted engaging in this conduct and has agreed to cooperate with the Government.
“Paying kickbacks for patient referrals erodes the integrity of our healthcare system and costs taxpayers precious dollars. Doctors must put patients first, not treat them like commodities unscrupulously paid for with government funds,” stated Acting United States Attorney DuCharme. Mr. DuCharme expressed his grateful appreciation to the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), and the New York State Attorney General for their assistance with the case.
“The OPM-OIG has zero tolerance for fraud against the Federal Employees Health Benefits Program (FEHBP). Submitting false claims for services that are not medically necessary and creating false documentation to justify procedure undermines the FEHBP, wastes taxpayer dollars, and increases the cost of medical care for us all,” stated OPM-OIG Deputy Inspector General Vint. “This settlement is a result of the hard work of our investigative staff and our partners at the U.S. Attorney’s Office, EDNY, FBI, HHS OIG, and the New York State Attorney General’s office.”
The agreement resolves a lawsuit originally brought by a whistleblower under the qui tam, or whistleblower, provisions of the False Claims Act, captioned United States ex rel. FNU LNU LLC v. New York Cardiology P.C., et al., Civil No. 14-4581 (EDNY). The False Claims Act permits private citizens with knowledge of fraud against the government to bring a lawsuit on behalf of the United States and to share in the recovery.
In 2018, Bhambhani surrendered his medical license after pleading guilty in the Eastern District of New York to one count of conspiracy to pay healthcare kickbacks. He was sentenced to 34 months in prison, three years’ supervised release and ordered to pay $217,364.83 in criminal restitution and $1,080,000 in criminal forfeiture.
The government’s case was handled by Assistant U.S. Attorney Lisa Kutlin of the Office’s Civil Division, with assistance from Affirmative Civil Enforcement Auditor Michael Gambrell.