NY doctor indicted for defrauding Medicaid and giving patients invasive and medically unnecessary testing

Payam Toobian, M.D., New York, and his company, America’s Imaging Center, Inc. (America’s Imaging), for defrauding Medicaid by forcing patients to get unnecessary and invasive medical tests. Toobian is alleged to have run a kickback scheme where he bribed other physicians for patient referrals, subjecting some of those patients to tests and procedures that they did not need, and then caused false claims to be submitted to Medicaid for those tests. Toobian, through his corporation America’s Imaging, operated Empire Imaging, a diagnostic radiology center in Forest Hills, Queens. Toobian was charged with Grand Larceny in the Third Degree, Health Care Fraud in the Third Degree, eight counts of Falsifying Business Records in the First Degree, and three counts of violating the Social Services Law statute prohibiting the payment of kickbacks related to the provision of services under the state’s Medicaid program, all felony charges. 

From January 2006 to August 2017, Toobian allegedly gave gift cards, cash, and checks totaling more than $547,000 to three physicians in exchange for the physicians’ referral of patients (including Medicaid beneficiaries) to Empire Imaging. Empire Imaging received more than $1 million in paid claims relating to patient referrals from those physicians. In addition to this kickback scheme, from January 2014 to August 2017, Toobian allegedly directed his employees at Empire Imaging to add additional, unordered radiological procedures to orders submitted by referring physicians to increase the amount of money Empire Imaging would receive from Medicaid. 

Toobian allegedly 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, unnecessary 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 Office of the Attorney General (OAG) is also, in a separate civil lawsuit filed in the United States District Court for the Eastern District of New York, seeking damages from Toobian and America’s Imaging, among other defendants, for violating the Federal and New York State False Claims Act and for other civil causes of action. 

The criminal case is being prosecuted by Special Assistant Attorneys General Peter Zadek and Robert Trudell under the supervision of Thom O’Hanlon, Chief of MFCU Criminal Investigations–Downstate. The civil case is being handled by Special Assistant Attorney General Jared Goldman with assistance from Konrad Payne, Deputy Chief of the MFCU Civil Enforcement Division and MFCU Civil Enforcement Division Chief Alee Scott. The 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

Jeffrey Newman is a whistleblower lawyer with the firm Newman & Shapiro. He can be reached at 978-880-4758 or Jnewman@newmanshapiro.com