WASHINGTON and CINCINNATI, May 1, 2023 /PRNewswire/ -- SouthEast Eye Specialists, together with SouthEast Eye Surgery Center and the Eye Surgery Center of Chattanooga (SEES), agreed to pay the United States and Tennessee $17,000,000 to resolve allegations that they violated the Anti-Kickback Statute by illegally inducing primary-care eye doctors (optometrists) to refer – or steer –patients to SEES for cataract surgeries by providing optometrists a variety of forms of financial remuneration. Those optometrists provided referrals to SEES for cataract surgeries reimbursed by Medicare and TennCare, resulting in alleged violations of the False Claims Act.
Represented by Phillips & Cohen LLP and Morgan Verkamp LLC, two whistleblowers alleged in a False Claims Act lawsuit that SEES used a variety of approaches to secure a stream of referrals by inducing optometrists to refer patients to SEES, including continuing education, meals, sporting events, and inappropriate pre-arranged co-management agreements with optometrists.
When cataract surgery is co-managed, the surgeon performing the surgery retains 80% of the Medicare reimbursement, and the referring optometrist doing the post-operative exam receives 20% of the payment. When done appropriately, co-management is decided on a case-by-case basis with considerations for patient health, patient convenience, and patient choice.
The settled complaint alleged that SEES corrupted this relationship by using it to serve its own...
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