Federal enforcers have resolved at least four fraud cases tied to ASCs so far in 2026, totaling about $11.3 million, according to announcements from the Justice Department and HHS’ Office of Inspector General.
The cases involve Stark law and Anti-Kickback Statute allegations, a drugmaker’s kickbacks to ASCs and claims for services by an unlicensed nurse. Three of the four came out of voluntary self-disclosures.
Here are the cases, in the order they were announced:
1. Southwest Orthopedic and Spine Hospital, USPI and Dignity/USP Phoenix Surgery Centers: $5.6 million (Feb. 24).
The Phoenix surgical hospital, which does business as OASIS Hospital, allegedly made improper payments from 2011 to 2018 to a physician group that referred patients to it. The payments came as interest on convertible bonds issued to the group. USPI disclosed the arrangements after a 2019 internal compliance review, and the Justice Department gave the companies credit for cooperating. The claims are allegations only, and there has been no determination of liability.
2. PSA Ambulatory Surgery Center of Killeen (Texas): $46,730 (April 29).
The ASC allegedly submitted Tricare claims for services by an unlicensed nurse, in violation of the Civil Monetary Penalties Law. The amount equals the full salary and benefits the nurse was paid while working without a license.
3. EyePoint Pharmaceuticals: about $4.68 million (July 17).
The Waltham, Mass.-based drugmaker will pay about $4.66 million to the federal government and $21,519 to participating states. From January 2019 to March 2023, EyePoint’s “Assurance Program” allegedly reimbursed ASCs when insurers denied or underpaid claims for Dexycu, an injectable for inflammation after cataract surgery. The company also allegedly gave ASCs excessive free samples to get them to buy the drug. EyePoint signed a five-year corporate integrity agreement with the OIG.
4. Campus Eye Management: $1 million in restitution (July 29).
The Justice Department declined to prosecute the company, a management services organization that provides billing and other services to an optometry practice and an ASC. It was the first healthcare resolution under the department’s Corporate Enforcement and Voluntary Self-Disclosure Policy. Founder and former CEO E. Bruce DiDonato faces a seven-count indictment. Prosecutors allege he paid ophthalmologists kickbacks for surgery referrals, hidden through sham consulting agreements, and billed Medicare for unnecessary diagnostic tests. The alleged false claims totaled about $3.4 million, and Medicare paid about $1 million of that.
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