Two New York ophthalmology practices have agreed to pay a combined $2.3 million to settle allegations that they violated the False Claims Act by billing federal health care programs for medically unnecessary testing through an alleged kickback arrangement, the Justice Department announced.
Mark D. Fromer, P.C., doing business as Fromer Eye Centers, and Floral Park Ophthalmology P.C. allegedly submitted or caused the submission of false Medicare claims for trans-cranial doppler ultrasounds, or TCDs, according to the Justice Department. Fromer Eye Centers also allegedly submitted or caused the submission of false Medicaid claims. The Estate of Mark Fromer, the former owner of Fromer Eye Centers, joined in the settlement with the practice.
The United States alleged that the practices worked with a third-party testing company to identify patients as having a serious diagnosis that could qualify them for TCD reimbursement before the patients had received their test results. However, the government alleged that nearly all patients who underwent the tests never had that diagnosis and that it was not reflected in their medical histories or TCD results.
Floral Park Ophthalmology also allegedly received remuneration from the testing company to induce referrals of Medicare and Medicaid patients. The department specified that its allegation involving the submission of false Medicaid claims applied to Fromer Eye Centers.
The government alleged that the scheme resulted in false claims...
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