Brooklyn cardiologist charged with health care fraud and bribery

The U.S. Attorney's Office for the Southern District of New York also filed a civil fraud complaint today under the False Claims Act against MITTAL, DIVANSHU BANSAL, who manages MITTAL's medical practice and supervises staff, and NIRANJAN K. MITTAL, PHYSICIAN, PLLC d/b/a/ CARECUBE, and NEW YORK PET IMAGING CENTER LLC, the entities that own MITTAL's practice and diagnostic testing facility. MITTAL was presented in federal court before U.S. Magistrate Judge Ona T. Wang. The case is assigned to U.S. District Judge Ronnie Abrams.

U.S. Attorney Damian Williams said: "We put our faith in doctors and trust their expertise. As alleged, Dr. Niranjan Mittal betrayed that trust. He subjected patients to surgical procedures that they did not need. He directed his staff to make up patient symptoms in medical records to justify these unnecessary procedures so he could receive lucrative insurance payments, and he bribed other doctors to send him their patients. Thanks to our law enforcement partners, Mittal now faces criminal prosecution and civil penalties for his alleged conduct."

HHS-OIG Special Agent in Charge Naomi Gruchacz said: "Health care providers who falsify records and recommend medically unnecessary services to drive up profits pose a significant risk to patients. HHS-OIG will continue to work with our law enforcement partners to hold accountable individuals who, to satisfy their own greed, exploit federal health care programs."

HSI Acting Special Agent in Charge Erin Keegan said: "Niranjan Mittal is accused of defrauding the government and private insurers of millions of dollars while treating his patients like commodities he could use to further enrich himself. He put profit over patient well-being, convincing individuals who sought his care to undergo potentially unnecessary medical procedures. Through partnerships, such as those established within HSI's Document and Benefits Fraud Task Force, we are actively raising awareness among the public and deterring those who aim to exploit the vulnerable."

IRS-CI Special Agent in Charge Thomas Fattorusso said: "While Dr. Mittal may have taken the Hippocratic Oath when he became a doctor, the irony is not lost on the hypocrisy of his alleged fraud, where instead of caring for his patients, he cared for himself and lining his own pockets. Mittal's alleged schemes were devoid of concern for his patients, and his practice to treat certain patients with unnecessary procedures is outright dangerous. Today's arrest ensures that he will no longer be able to continue his fraud and victimize those who sought legitimate care and treatment."

According to the Indictment:[/1]

Since at least 2016, MITTAL operated a medical clinic in Brooklyn, New York (the "Brooklyn Clinic"), with a patient base consisting of many individuals of limited economic means who were insured by government health care programs. In order to ensure a steady flow of new patients to the Brooklyn Clinic, MITTAL paid rental payments to other providers pursuant to purported "leases" for office space. Often, however, the timing and amount of the payments bore no relation to the terms of those leases. In fact, MITTAL made the purported lease payments to induce other providers to refer patients to MITTAL's staff members, who, at the direction of MITTAL, periodically traveled to the providers' offices, performed basic tests on the referred patients, and convinced the patients to attend follow-up appointments at the Brooklyn Clinic.

Once patients arrived at the Brooklyn Clinic, often without understanding why they had been referred to the practice, they underwent a series of diagnostic tests and follow-up office visits. These tests and office visits generally were not based on the patients' actual treatment needs. Rather, MITTAL and others acting at his direction ordered these tests and office visits to create documentation sufficient to justify subjecting patients to unnecessary peripheral vascular interventional procedures--surgical procedures focused on clearing purported blockages in the blood vessels in patients' legs. MITTAL directed others to, among other things, fabricate the descriptions of patients' symptoms recorded in the practice's office visit notes, varying the symptoms across patients so that it was not apparent that the symptoms were fake.

As a result of MITTAL's scheme, patients at the Brooklyn Clinic, many of whom were already in poor health, routinely underwent medically unnecessary vascular interventions at MITTAL's office, with some patients undergoing ten or more interventional procedures over the course of several years. The patients' conditions often did not improve, despite these repeated interventions. Through his operating entity, MITTAL billed Medicare, Medicaid, and private insurers over $100 million for the relevant vascular procedures.

According to the Civil Complaint: [/2]

In addition to fraudulently billing Medicare and Medicaid for medically unnecessary peripheral vascular procedures, fabricating patient records to make it appear these procedures were justified, and paying kickbacks for patient referrals:

MITTAL, BANSAL, and MITTAL's operating entities billed Medicare and Medicaid for medically unnecessary cardiac diagnostic imaging studies, including but not limited to PET scans, stress tests, echocardiograms, and carotid artery doppler studies. These tests were repeatedly performed on the same patients without any clinical basis and without taking into account the results of prior, duplicative tests. At the direction of MITTAL and BANSAL, staff prepared fabricated medical records to make it appear that patients exhibited symptoms and complaints that would justify performing these tests. The lawsuit seeks to recover treble damages and civil penalties under the False Claims Act.

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MITTAL, 70, of Brooklyn, New York, is charged with one count of conspiracy to commit health care fraud and wire fraud, which carries a maximum sentence of 20 years in prison, one count of health care fraud, which carries a maximum sentence of ten years in prison, one count of conspiracy to violate the Anti-Kickback Statute, which carries a maximum sentence of five years in prison, and one count of violation of the Anti-Kickback Statute, which carries a maximum sentence of 10 years in prison.

The maximum potential sentences are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendant will be determined by the judge.

Mr. Williams praised the outstanding investigative work of HHS-OIG, HSI, and IRS-CI.

The criminal case is being handled by the Office's Complex Frauds and Cybercrime Unit. Assistant U.S. Attorneys Patrick R. Moroney and Matthew Weinberg are in charge of the prosecution. The civil lawsuit is being handled by the Office's Civil Frauds Unit. Assistant U.S. Attorneys Jeffrey K. Powell and Pierre G. Armand are in charge of the civil case.

The charges contained in the Indictment are merely allegations, and the defendant is presumed innocent unless and until proven guilty.

If you or someone you know has information about the conduct at MITTAL's cardiology practice, please call the HHS-OIG tip line at 1-800-HHS-TIPS.

[1/] As the introductory phrase signifies, the entirety of the text of the Indictment, and the description of the Indictment set forth herein, constitute only allegations, and every fact described should be treated as an allegation.

[2/] As the introductory phrase signifies, the entirety of the text of the Complaint and the description of the Complaint set forth herein constitute only allegations, and every fact described should be treated as an allegation.

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Original text here: https://www.justice.gov/usao-sdny/pr/brooklyn-cardiologist-charged-health-care-fraud-and-bribery