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A Supreme Court justice in Albany, N.Y., has accused a medical group and a physician of fraud for doctoring an employment contract. Justice Thomas J. Spargo said the doctor and his employer deliberately misled federal authorities so the physician, a citizen of India, could work in this country without the proper visa. But the judge refused to enforce any part of a noncompete contract that brought the matter to light. Prime Medical Associates v. Ramani, 00-0860, is rooted in a rural community’s need for an infectious-disease specialist and the federal government’s effort to meet it. The Columbia-Greene county region in New York is designated a medically underserved area by the U.S. Department of Agriculture and a health professional shortage area by the Department of Health and Human Services. Because of those designations, the government will waive certain work visa requirements for eligible individuals. The doctor, Ananthakrishnan Ramani, contracted to work for Prime Medical Associates at the group’s medical centers in Columbia and Greene counties. The contract included a noncompete clause that barred Ramani from competing against Prime Medical Associates within 25 miles for two years after leaving that practice. The deal was contingent on Ramani’s securing a work visa. The Department of Agriculture objected to the noncompete clause, saying it would subvert the aim of the visa-waiver program. After the department declined to waive the work visa requirements for Ramani, a new contract was executed without that clause and approved by the federal government. However, according to court papers, Prime Medical Associates required Ramani to sign an amendment to his contract and a promissory note that together restored the noncompete clause and attached a monetary penalty. Neither document was revealed to federal authorities, even though both Prime and Ramani were well aware that the Agriculture Department would not waive visa requirements if a noncompete contract was in effect, Justice Spargo said. The litigation ensued when Prime and Ramani had a falling out and the doctor joined a rival medical practice. Prime sued to enforce the noncompete clause, and Ramani counterclaimed with an action against Prime. Justice Spargo, in a decision that is unusual in that it declines to enforce any part of a noncompete clause, said the provision clearly contravenes public policy. “Dr. Ramani is the only infectious disease specialist serving the Columbia-Greene area,” he wrote. “The court thus finds that enforcement of the non-compete clause would pose a substantial risk of harm to the public.” Additionally, the judge said he “will not condone the submission of an apparently fraudulent document to the federal government for the purpose of obtaining a visa � Ramani and Prime acted in concert to fraudulently obtain the visa and to defeat the very purpose of the visa waiver program.” Prime Medical Associates was represented by Thomas D. Buchanan of Hacker & Murphy in Latham, Albany County. Paul M. Freeman of Connor, Curran & Schram in Hudson appeared for Ramani. Dennis H. McCoobery of Garfunkel, Wild & Travis in Great Neck represents Columbia Memorial Hospital, Ramani’s current employer. Buchanan and Freeman were unavailable for comment.

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