NY Ophthalmology Practices to Pay $2.3 Million to Resolve FCA Claims

Two Long Island ophthalmology practices have agreed to return $2.3 million in payments from state and federal government programs based on the ordering of unnecessary trans-cranial doppler ultrasounds (TCDs). The lawsuit brought by a whistleblower under the False Claims Act (FCA) against Mark D. Fromer, P.C., dba Fromer Eye Centers, and Floral Park Ophthalmology P.C. alleged that the testing was not medically indicated and that the practices were paid a kickback for each test ordered.

To justify ordering a TCD, which costs around $100 per test, a patient would need to have a serious diagnosis. The government made its case after a review of the medical records found no diagnosis that warranted ordering a TCD test. In addition, the overwhelming negative findings in the test results demonstrated the lack of a medically indicated diagnoses. Payments from the testing company back to the ophthalmology practices for referring patients sealed the government’s case against the practices.

The settlement funds will be shared between the federal and state governments to reimburse the Medicare and Medicaid programs, and the whistleblower will receive approximately $132,000. The settlement is the latest in a string of FCA cases involving unnecessary TCDs.

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