New York Attorney General Letitia James announced that a jury found Payam Toobian, M.D. of Kings Point, New York, and his company, America’s Imaging Center, Inc., guilty on charges related to running a kickback scheme that defrauded Medicaid and subjected patients to invasive procedures they did not need. In August 2022, the Office of the Attorney General (OAG) indicted Toobian, and today he was found guilty of Grand Larceny in the Third Degree, Health Care Fraud in the Third Degree, four of eight counts of Falsifying Business Records in the First Degree, and two counts of violating the Social Services Law statute prohibiting the payment of kickbacks, all felony charges.
“All New Yorkers should be able to trust that their doctors are prioritizing their health, not simply using them to upcharge insurance companies,” said Attorney General James. “For years, Payam Toobian subjected patients to unnecessary and often invasive tests in order to enrich himself. Today’s verdict will ensure he is held accountable for defrauding Medicaid and putting New Yorkers at risk. My office will continue to pursue any medical provider who attempts to profit at the expense of those in need of care.”
From January 2006 to August 2017, Toobian ran a kickback scheme in which he gave gift cards and cash to two physicians in exchange for the physicians’ referral of patients. In addition, from January 2014 to August 2017, Toobian directed his employees to add additional, unordered radiological procedures to orders submitted by referring physicians to increase the amount of money received from Medicaid.
Toobian defrauded Medicaid and subjected patients to medically unnecessary and often invasive radiological testing without the direction, consent, or approval of the referring physicians responsible for the underlying care of those patients. The additional tests included MRIs of the brain, cervical spine, and lumbar spine, all “with contrast,” which required subjecting patients to unnecessary and invasive injections. Toobian then directed his staff to submit claims for payment to Medicaid for those medically unnecessary tests.
The OAG would like to thank the U.S. Department of Health and Human Services, Office of the Inspector General, the New York State Department of Health, and Medicaid MCOs, HealthFirst, MetroPlusHealth, and United Healthcare, for their cooperation and valuable assistance throughout the investigation.
MFCU’s investigation was led by Detectives Thomas Bolen, Robert Hatt, Dawn Scandaliato, and Michael McNally, with the assistance of Acting Assistant Chief Ronald Lynch and Deputy Chief William Falk. Trial and administrative support was provided by Detectives Thomas Fisch, Allison Gionta, and Adrian Klapper, Legal Support Analysts Anne Liptak, Kelvin Caraballo, and Caroline Lindeman, and MFCU’s Electronic Investigative Support Group. The investigative financial analysis was presented by Principal Auditor-Investigator Deowattie Persaud and Senior Auditor-Investigator Khristian Diaz, with assistance from Regional Chief Auditor Stacey Millis.
The OAG was represented at trial by Special Assistant Attorneys General Robert Trudell and Samantha McCullagh, with the assistance of Special Assistant A.G. Ferron Lien, under the supervision of Thomas O’Hanlon, Chief of MFCU Criminal Investigations. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. The Division for Criminal Justice is led by Chief Deputy Attorney General José Maldonado and overseen by First Deputy Attorney General Jennifer Levy.
MFCU defends the public by addressing Medicaid provider fraud and protecting nursing home residents from abuse and neglect. If an individual believes they have information about Medicaid provider fraud or about an incident of abuse or neglect of a nursing home resident, they can file a confidential complaint online on OAG website or by calling MFCU's hotline at (800) 771-7755. If the situation is an emergency, please call 911.
New York MFCU’s total funding for federal fiscal year (FY) 2024 is $68,997,928. Of that total, 75 percent, or $51,748,448, is awarded under a grant from the U.S. Department of Health and Human Services. The remaining 25 percent, totaling $17,249,480 for FY 2024, is funded by New York state.
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