Brandon Eye Associates PA, an ophthalmology practice with offices in Brandon, Sun City and Plant City, Florida, has agreed to pay $1.3 million to resolve alleged violations of the False Claims Act and an analogous Florida statute arising from its billing for trans-cranial doppler ultrasounds (TCDs) provided through a kickback arrangement with a third party. Brandon Eye has agreed to cooperate with the Justice Department’s investigations of other participants in the alleged scheme. The settlement resolves allegations that Brandon Eye knowingly submitted, and caused the submission of false claims for medically unnecessary TCDs performed on Brandon Eye’s patients. Brandon Eye and a third-party provider of turnkey mobile TCD services, through an agreement, performed TCDs on Brandon Eye patients who had been diagnosed with common health conditions such as diabetes, hypertension and glaucoma. Before the patient received the TCD result, Brandon Eye and the third-party provider identified the patients as having received a serious diagnosis—most commonly of occlusion and stenosis of their cerebral arteries—that could qualify the patient for reimbursement of a TCD by Medicare or Medicaid.
However, nearly all patients who received TCDs never had occlusion and stenosis of cerebral arteries, and that diagnosis was accordingly not reflected in the patient’s medical history or in the TCD results. The United States alleged that as a result of this scheme, Brandon Eye submitted, or caused the submission of, false claims to Medicare and Medicaid for TCDs that were medically unnecessary, that were premised on false diagnoses, and that resulted from violations of the Anti-Kickback Statute and the Stark Law. Of the $1.3 million total settlement amount, $1,210,245.70 is to be paid to the United States, and $89,754.30 is to be paid to the State of Florida for its share of Medicaid, which is a jointly funded federal and state program.
