North Texas ophthalmology group agrees to pay $2.9M to settle kickback allegations
SHERMAN (CBSNewsTexas.com) — A North Texas ophthalmology group has agreed to pay over $2.9 million to settle allegations that it improperly paid kickbacks to doctors who referred patients to them for surgery.
Arlington Ophthalmology Association, PLLC - also known as Kleiman Evangelista Eye Centers (K&E) - will pay $2,902,505 to resolve civil allegations that it offered and paid kickbacks to optometrists to encourage referrals of patients for cataract surgery.
The alleged practices violate the Anti-Kickback Statute of the False Claims Act, prosecutors claim. The statute prohibits to offering, paying for, soliciting, or receiving payment for referrals of "items or services covered by Medicare, Medicaid, and other federally funded programs."
It's intended to ensure that medical providers are able to make decisions without being compromised by financial incentives.
K&E routinely practiced "co-management" of cataract surgery patients with outside optometrists who referred patients to K&E. The patients would receive post-surgery care from the referring optometrists rather than the surgeon's practice.
According to federal prosecutors, aspects of this arrangement violated the Anti-Kickback Statute. They contended that K&E paid optometrists money for referring cataract patients who received certain treatments, guaranteed the automatic return of referred patients, provided referrers with free continuing education courses, rewarded top referrers with expensive dinners, and invited referring optometrists, their families, and staff to Texas Rangers games.
Because the money paid to the optometrists was in addition to reimbursement already received from Medicare and Medicaid for post-operative care and was not tied to the actual post-operative services, it constituted unlawful remuneration according to the Anti-Kickback Statute.
As part of the settlement, K&E agreed cooperate with any investigations into other parties involved in the allegations.
The whistleblower who filed the civil lawsuit under the False Claims Act will receive a portion of the settlement.
