TL/DR –
A 63-year-old anesthesiologist and pain medicine doctor, Dr. Ajay Aggarwal from Houston, has agreed to pay over $2 million to settle allegations of submitting false claims to federally funded health care programs. These claims were made for the surgical implantation of neurostimulator electrodes, a costly and invasive procedure, but neither Aggarwal nor his staff carried out these surgeries, instead allegedly using less invasive techniques involving electro-acupuncture. The U.S. Attorney’s Office, which conducted the investigation, emphasized the importance of holding accountable those who defraud federal benefit programs.
Houston Doctor to Pay Over $2 Million for Alleged False Claims
A 63-year-old Houston medical professional, Dr. Ajay Aggarwal, has consented to pay $2,053,515 to settle allegations of submitting false claims to federally funded health care programs such as Medicare and Department of Labor’s Workers’ Compensation programs. Dr. Aggarwal, an anesthesiologist and pain medicine doctor, operated under the entities Ajay Aggarwal, a sole proprietorship, and PRWCSWTX LLC for his medical practice, The Pain Relief & Wellness Center.
Details of the Allegations
Between Nov. 16, 2021, and March 28, 2023, Aggarwal allegedly billed these programs for surgical implantation of neurostimulator electrodes, invasive procedures usually requiring an operating room. However, the allegations suggest that neither Aggarwal nor his staff performed these procedures. Patients were purportedly given devices for electro-acupuncture involving minimal invasive procedures.
Lack of Surgical Procedures
According to the allegations, the devices were merely inserted a few millimeters into patients’ ears and taped behind the ear with an adhesive. These procedures took place in Aggarwal’s clinic, not a hospital or surgical center, and no incision was made on any patients.
Statements from Officials
A statement from U.S. Attorney Nicholas J. Ganjei highlighted the fraudulent nature of billing Medicare for sophisticated surgery when only simple medical devices were used. Other officials, including Special Agent in Charge Jonathan Ulrich of the USPS-OIG, and Special Agent in Charge Casey Howard, DOL-OIG, Central Region, pledged continued efforts to protect federally funded healthcare programs and federal health care programs from fraudulent activities.
The investigation was conducted by the U.S. Attorney’s Office, with significant assistance from the OIG offices of USPS, DOL, and DHHS.
Please note that the allegations have only been resolved by the settlement, and there is yet to be a determination of liability.
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