Five Florida ophthalmology practices agreed to pay nearly $6 million to resolve allegations of submitting false claims to Medicare and Medicaid for medically unnecessary transcranial doppler ultrasounds, according to a Jan. 15 news release from the Justice Department.
What happened?
- The practices — Fleming Island-based Clay Eye Holdings, Retina Macula Specialist of Miami, Vero Beach-based Florida Eye Institute, Miami Eye and Kendale Lakes-based Kendall Eye Institute — allegedly participated in a kickback scheme with a third-party testing company.
- Between Jan. 1, 2018 and June 1, 2022, the organizations performed and billed for TCDs based on false diagnoses and referred patients to a preferred radiology group, the Justice Department said.
- As part of the settlements, Clay Eye Holdings will pay $2,140,000, Retina Macula Specialist of Miami will pay $1,750,000, Florida Eye Institute will pay $1,250,000, Miami Eye will pay $525,000, and Kendall Eye Institute will pay $310,000. Of the total, $333,500 will go to the State of Florida for its share of Medicaid.
- A whistleblower lawsuit filed under the False Claims Act triggered the investigation. The whistleblower will receive $1.1 million from the settlements.
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