Ophthalmologist, practice to settle False Claims Act violation allegations for $5M: 3 details

Sherif Khalil, MD, an ophthalmologist, and his practice Beaver Medical Group will pay $5 million to settle false claims allegations related to Medicare Advantage plan billing.

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Three things to know:

1. Dr. Khalil and Redlands, Calif.-based Beaver Medical Group allegedly reported invalid diagnosis codes for patients with Medicare Advantage plans.

2. A former employee of the clinic brought the original lawsuit against Dr. Khalil and Beaver Medical, alleging they knowingly submitted additional diagnosis codes to increase payments, even though the codes weren’t supported in the beneficiaries’ medical records.

3. The $5 million settlement resolves the allegations, and the whistleblower received $850,000.

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