Attorney General James Announces Indictment of Long Island Physician for Defrauding Medicaid and Subjecting Patients to Invasive and Medically Unnecessary Testing

Payam Toobian, M.D., Allegedly Paid Kickbacks to Physicians for Patient
Referrals and Subjected Medicaid Patients to Unnecessary Radiological Tests 

New York – New York Attorney General Letitia James today announced the indictment of Payam Toobian, M.D., 52, of Kings Point, 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. For years, Toobian allegedly ran a kickback scheme where he bribed other physicians for patient referrals, subjected 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.

Attorney General Latitia James

“New Yorkers should be able to trust that their doctors are working to heal them, not profit off of their suffering,” said Attorney General James. “Bribery and kickback schemes corrupt our healthcare system and make it impossible for patients to receive the care that they need. The idea that a licensed physician would subject patients to unnecessary testing to line their pockets is unconscionable, and my office will continue to go after medical providers that jeopardize the health and safety of New Yorkers.”

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 OAG would like to thank the U.S. Department of Health and Human Services, Office of the Inspector General, 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 Supervising Detective Ronald Lynch, Deputy Chief Kenneth Morgan, and Deputy Chief William Falk. The underlying financial analysis was completed by Senior Auditor-Investigator Deowattie Persaud and Auditor-Investigator Khristian Diaz, with assistance from Regional Chief Auditor Stacey Millis.

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.

The charges filed in this case are merely accusations. The defendants are presumed innocent unless and until proven guilty in a court of law.

New York MFCU’s total funding for federal fiscal year (FY) 2022 is $59,918,216. Of that total, 75 percent, or $44,938,664, is awarded under a grant from the U.S. Department of Health and Human Services. The remaining 25 percent, totaling $14,979,552 for FY 2022, is funded by New York state.

Reporting Medicaid Provider Fraud: 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 or call the MFCU hotline at (800) 771-7755. If the situation is an emergency, please call 911.