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Gift Cards

Healthcare-10
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

It’s hard to remember how we lived without gift cards, but they weren’t invented until 1994. Neiman Marcus was the first to sell the cards, although they didn’t advertise and display them. It was Blockbuster who first displayed the gift card in its stores. The next big gift card seller was Starbucks, who in 2001 introduced cards that worked more than once. The rest, as they say, is history. In 2022, $173 billion gift cards were purchased. So popular are these gift cards that they are now even a form of bribe for fraudsters.

From January 2006 to August 2017, Dr. Toobian operated a kickback scheme where he paid two physicians almost a half a million dollars in gift cards in exchange for patient referrals. From this scheme, Toobian’s company earned $1 million in paid claims related to those referrals. But Toobian didn’t stop there. Unfortunately, Toobians scheme becomes unforgivable.

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.

On November 26, 2023, Toobian was convicted of Medicaid fraud. Great job by the Office of the Attorney General in this case.

Today’s Fraud of The Day is based on article “New York Doctor Convicted in Kickback Scheme Defrauding Medicaid” published by WNY News Now on November 26, 2023

A jury has convicted Dr. Payam Toobian and his company, America’s Imaging Center, Inc., on charges related to a kickback scheme that defrauded Medicaid and exposed patients to unnecessary invasive procedures. The verdict comes after Toobian was indicted by the Office of the Attorney General (OAG) in August 2022.

Toobian, based in Kings Point, New York, was found guilty on multiple felony charges, including Grand Larceny in the Third Degree, Health Care Fraud in the Third Degree, Falsifying Business Records in the First Degree, and violating the Social Services Law statute prohibiting kickbacks. The charges stem from a kickback scheme operated by Toobian from January 2006 to August 2017, involving gift cards and cash payments to physicians in exchange for patient referrals. Additionally, Toobian directed the unauthorized addition of radiological procedures to orders submitted to Medicaid, increasing financial gains.

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