Medical practitioner convicted of fraud has registration suspended by tribunal

09 Mar 2018

A tribunal has reprimanded, suspended and imposed conditions on the registration of a medical practitioner convicted of fraudulently obtaining payments

The Victorian Civil Administrative Tribunal (the tribunal) found in November 2017 that Dr Pralay Mazumdar, a specialist psychiatrist, had engaged in professional misconduct and unprofessional conduct.

The Medical Board of Australia (the Board) referred the matter to the tribunal in August 2016 after it received a notification alleging the practitioner’s ‘systematic fraudulent billing of many patients’ and after an investigation by the Victorian WorkCover Authority (VWA) was complete.

Following the VWA investigation Dr Mazumdar pleaded guilty and was convicted in the Magistrates’ Court at Ringwood in December 2014 of offences under the Accident Compensation Act 1985 for:

• fraudulently obtaining payments
• knowingly providing false information, and
• providing false or misleading information.

Dr Mazumdar’s conduct involved systematic overcharging of the VWA by fraudulently obtaining payments on 114 occasions, including as a result of making false representations to patients between March 2012 and September 2013. The total amount involved was $44,539.

On 11 December 2014, Dr Mazumdar was sentenced to six months' imprisonment, which was suspended for nine months, and was fined $5,000. Dr Mazumdar appealed this decision and this resulted in the County Court again convicting Dr Mazumdar in August 2015 and the fine remaining, although the suspended prison sentence was set aside and a Community Corrections Order for two years, including 350 hours of community service, was imposed instead.

During the County Court’s sentencing his Honour Judge Tinney commented that: 'Really, there is no explanation placed before me, which leaves the obvious explanation and the only one remaining in my judgment. That is greed.’

He added: 'This court has to send a message loud and clear to other practitioners, be they psychiatrists or doctors, or even allied healthcare professionals working within these schemes that take the word of a practitioner. That trust not be and cannot be breached, and if it is, there is a substantial punishment awaiting those who take those criminal steps.'

The tribunal’s finding of professional misconduct related to Dr Mazumdar’s criminal convictions and its finding of unprofessional conduct related to his failure to advise the Board that his clinical privileges at the clinic where he worked had been suspended, as is required under the National Law^1.

The tribunal reprimanded Dr Mazumdar and suspended his registration for six months from 1 January 2018.

Conditions were also imposed on his registration, including to:

• undertake education about billing practices and professional behavior, during the suspension period,
• attend for mentoring, following his return to practise, and
• submit to audits of his practice, to focus on billing practices, following his return to practice.

The tribunal found that Dr Mazumdar’s misconduct would be serious if committed by any practitioner at any stage of their career.

The tribunal stated: ‘In this case, it is especially grave having regard to the age, experience and reputation of Dr Mazumdar. He presented himself as someone of impeccable character; someone whom his peers might hold up as manifesting the highest ideals of the profession; someone whom his patients might be expected to trust implicitly. There is no question that these assumptions and expectations were utterly negated by the misconduct...’

The tribunal also found that his conduct in failing to advise the Board of his change in circumstances reflected ‘a serious avoidance of responsibility and professional obligations owed to the regulatory authority’.

Reasons for the decision are published on the Austlii website.

¹ Section 130 of the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).