Florida-based Brandon Eye Associates P.A. is set to pay $1.3 million in a move to settle claims of fraudulent billing practices involving trans-cranial doppler ultrasounds (TCDs). This settlement comes in the wake of allegations that Brandon Eye, which operates in several locations including Brandon, Sun City, and Plant City, participated in a kickback scheme, consequently billing for unnecessary medical services, as per an announcement by the
U.S. Attorney’s Office for the Middle District of Florida
.
The heart of the dispute lies in claims that Brandon Eye knowingly submitted or was the cause of the submission of false claims to federal health care programs for TCDs that were not medically necessary, and conducted under false pretenses that purported patients had been diagnosed with serious conditions such as occlusion and stenosis of the cerebral arteries, which in most cases were not true diagnoses reflective of the patients’ actual medical history, as the
Justice Department
stated. The agreement with a third-party provider not only facilitated this malpractice but also involved payment based on the volume of tests ordered, which evidently emphasized quantity over the sanctity of quality healthcare provisions.
Of the total sum, $1,210,245.70 will be directed to the United States, while Florida’s Medicaid system, which is jointly funded by both state and federal resources, will receive $89,754.30 according to
the announcement
. This financial recuperation stands as a testament to the government’s rigorous campaign against health care fraud, harnessing the prowess of the False Claims Act which continues to be instrumental in exposing and penalizing deceptive practices in the medical field.
Authorities including the Justice Department, the FBI, and the HHS-OIG have expressed their commitment to rooting out such immoral undertakings that not only undermine federal health care programs, but also betray the trust of American citizens, feeling as the U.S. Attorney Roger Handberg has observed, “these actions against providers who exploit federal health care programs for personal gain,” must continue to ensure justice and protecting the integrity of these programs, the FBI and participating agencies work tirelessly to address allegations of illegal kickbacks preserving both the Medicare and Medicaid systems and those who rely on them, according to the
Justice Department
.
The case itself was spearheaded by numerous entities, including the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Middle District of Florida with Trial Attorney Nelson Wagner, and Assistant U.S. Attorney Mamie Wise handling the case. Health care fraud increasingly in the crosshairs of justice, tips, and complaints about potential misconduct remain crucial and are encouraged to be reported via HHS hotline at 1-800-HHS-TIPS (800-447-8477).
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