A Fleming Island ophthalmology practice is one of five in Florida that have agreed to pay a total of nearly $6 million to resolve an alleged kickback scheme, according to the U.S. Justice Department.
Clay Eye Holdings, which operates Clay Eye Physicians & Surgeons on East-West Parkway, joined others in Miami and Vero Beach who were accused of billing for ultrasounds through a kickback arrangement with a testing company, officials said.
All five practices have agreed to cooperate with the Justice Department’s investigations of other participants in the alleged scheme.
“Kickbacks and false claims increase health care costs for all Americans and undermine the integrity of health care decision-making,” Assistant Attorney General Brett A. Shumate said in a news release.
The settlements resolve allegations that the practices knowingly submitted false claims to Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds, or TCDs. The eye practices performed TCDs on thousands of patients, then billed Medicare and Medicaid hundreds of dollars per test, officials said.
Before the patients received their test results, the practices and the third party testing company said they received a serious diagnosis that could qualify them for reimbursement by Medicare or Medicaid. But almost all patients who received TCDs never had that diagnosis, and it was not reflected in their medical history or TCD results, according to the Justice Department.
The five...
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