Boston-based Ophthalmic Consultants of Boston has agreed to pay nearly $3.9 million to resolve False Claims Act allegations of improperly billing Medicare and MassHealth for office visits in addition to intravitreal injection procedures, the Justice Department said in a July 31 news release.
Between January 2015 and July 2025, OCB allegedly billed for office visits using a special billing modifier that permits separate reimbursement only under specific circumstances, without documentation to support the additional charges.
The Justice Department credited OCB for voluntary cooperation and disclosure in connection with the settlement. The case was initiated through a whistleblower complaint.
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