Eye doctor sentenced to 96 months in prison for billing and PPP loan fraud

Ameet Goyal, an ophthalmologist with offices in Fairfield, Westchester and Dutchess counties, was sentenced to 96 months in prison for running a seven-year healthcare fraud scheme that falsely billed millions of dollars coded procedures and for fraudulently obtaining two state-guaranteed loans.

Goyal owned and operated eye practices in Greenwich, Mount Kisco, Rye and Wappingers Falls. According to the charges against him, he systematically coded simpler, lower-paying surgical procedures and exams as complex, higher-paying major operations into fraudulent bills 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-billed doctor in the region. three states for several of his fraudulently billed codes—one of which he billed seven times more frequently than all doctors in the tri-state area combined.

Goyal was indicted on the health care 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 more than $630,000 in government-backed loans through the Paycheck Protection Program. In his loan applications, he falsely replied that he had no pending criminal charges and falsely certified that his business would not receive another PPP loan until the end of the year.

After securing the loans, he used the funds to pay for business and personal expenses, including payments to a Westchester country club, a California winery and a golf product website.

Goyal, who previously pleaded guilty to all charges in a six-count superseding indictment last September, was also sentenced to five years on probation and ordered to pay a $3.6million forfeiture dollars and a restitution of 3.6 million dollars. He has already paid around $1.79 million for these bonds.

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