The agreement adds two ophthalmology practices to a growing list of groups that have resolved similar allegations with the Justice Department.

Two New York ophthalmology practices—Fromer Eye Centers and Floral Park Ophthalmology P.C.—agreed to pay a combined $2.3 million to resolve allegations that they submitted false claims to Medicare and Medicaid for medically unnecessary transcranial Doppler ultrasounds. Federal prosecutors allege the practices billed Medicare and Medicaid after patients were identified as having diagnoses that could qualify them for reimbursement before test results were available, although the government alleged that nearly all patients never had those diagnoses.

The Justice Department also noted that it has previously resolved similar allegations involving seven other ophthalmology practices. They described the case as part of its broader effort to address health care fraud and referred to the False Claims Act as one of its most powerful enforcement tools.

Justice Department and Department of Health and Human Services Office of Inspector General officials said kickback arrangements can influence medical decision-making and increase health care costs while highlighting that investigating such conduct remains an enforcement priority. The department also highlighted the Administration's recently announced anti-fraud initiatives, including the Task Force to Eliminate Fraud and the National Fraud Enforcement Division.

Brett A. Shumate, Assistant Attorney General of the Justice Department's Civil Division, said, “The integrity of healthcare decision-making depends on sound medical advice that is free from undue influence of illegal kickbacks and other improper arrangements.”

The settlement resolves allegations, and the Justice Department noted there has been no determination of liability.

Source: US Department of Justice