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Business Observer Monday, Jul. 6, 2020 1 year ago

Practice, physician resolve fraud claims with $4.8 million settlement

The government alleged Sarasota-based Ophthalmic Consultants submitted false claims to Medicare, TRICARE and the Federal Employees Health Benefits Program.

SARASOTA — Ophthalmic Consultants P.A. and Dr. Robert Snyder have agreed to pay $4.8 million to resolve allegations of health care fraud.

According to a press release from the U.S. Attorney's Office for the Middle District of Florida, the government alleged Sarasota-based Ophthalmic Consultants submitted false claims to Medicare, TRICARE and the Federal Employees Health Benefits Program for treatments using the drugs ranibizumab (Lucentis) and aflipercept (Eylea) to treat patients who had wet age-related macular generation or other diseases of the eye.

Claims resolved by the settlement, the release states, are allegations only and there has been no determination of liability.

Authorities say although each vial contains a moderate overfill, Lucentis and Eylea are single-use medications not designed for multiple uses, and Ophthalmic Consultants engaged in the practice of multi-dosing (using a single drug vial to provide doses to multiple patients) to obtain excessive reimbursements from Medicare, TRICARE and FEHBP. 

As part of the settlement, Ophthalmic Consultants and Snyder entered into an Integrity Agreement with the Office of Inspector General, which promotes compliance with the statutes, regulations, program requirements and written directives of Medicare and all other federal health care programs. The IA includes, among other things, routine inventory requirements and requirements focusing on proper billing and submission of reimbursement claims, the statement says. 

The settlement was the result of a coordinated effort by the U.S. Attorney’s Office for the Middle District of Florida, the U.S. Department of Health and Human Services – Office of Inspector General, the Defense Criminal Investigative Service and the Office of Personnel Management – Office of the Inspector General. Assistant U.S. Attorney Christopher Emden handled the case.


“Anyone who seeks to exploit our healthcare system by submitting false claims to our federal health care programs will be held accountable for their actions,” says U.S. Attorney Maria Chapa Lopez in the statement. “Today’s settlement makes clear that the protection of our nation’s health programs is a priority for our Office and the Department of Justice.”

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