The organizations allegedly induced primary care physicians to steer patients to the two ASCs for cataract surgeries through financial remuneration, according to a May 1 news release. The optometrists provided referrals to the ASCs for cataract surgeries reimbursed by Medicare and TennCare, violating the False Claims Act, according to the report.
According to a false claims suit filed by two whistleblowers, the organizations offered continuing education, meals, tickets to sporting events and inappropriate, prearranged co-management agreements with optometrists, among other approaches, to recruit physicians.
The two whistleblowers, Ross Lumpkin, OD, a Tennessee optometrist, and Gary Odom, an executive in the statewide optometric association, alerted the government to the allegations.
“While we have not wavered in our view of the merits, we have reached a settlement to conclude this litigation and to eliminate any further financial, administrative, and operational burden on our organization stemming from this matter,” Southeast Eye Specialists said in a statement shared with Becker’s. “The settlement is a deliberate decision by our Board to put this matter behind us, allowing us to move forward with implementing exciting strategic initiatives and focusing dedicated resources toward our strong growth trajectory. It is important to note that there was no finding of any wrongdoing whatsoever. We continue to firmly believe that our practice was and continues to be in compliance with all applicable legal and medical ethical requirements and guidelines and we continue to hold ourselves to the very highest legal, ethical and compliance standards.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.