Two New York Eye Clinics Settle for $2.3M Over Medicare, Medicaid Fraud Claims
(New York = Alex Walczak) Two New York ophthalmology practices, Fromer Eye Centers and Floral Park Ophthalmology, have agreed to pay a combined $2.3 million to resolve allegations of fraudulent Medicare and Medicaid billing tied to unnecessary trans-cranial doppler ultrasounds (TCDs) and illegal kickback schemes.
The U.S. Department of Justice announced on July 31 that Fromer Eye Centers, owned by the late Mark Fromer, and Floral Park Ophthalmology P.C. settled claims accusing them of submitting false claims to Medicare and Medicaid. The clinics allegedly billed hundreds of dollars per TCD test performed on thousands of patients, despite most patients lacking the serious diagnoses required to justify the tests.
According to the DOJ, the clinics and a third-party testing company falsely classified patients as having serious conditions before test results were even delivered. This misclassification allowed them to bill federal health programs for medically unnecessary procedures. Floral Park Ophthalmology also allegedly received kickbacks from the testing company in exchange for referring Medicare and Medicaid patients.
These actions violated the Anti-Kickback Statute and the Stark Law, which prohibit financial incentives that influence medical decision-making. The DOJ emphasized that such schemes undermine the integrity of healthcare and inflate costs.
Under the settlement, Fromer Eye Centers and the Estate of Mark Fromer will pay $1.8 million, while Floral Park Ophthalmology will pay $500,000. Of the total, $384,000 will be reimbursed to New York State’s Medicaid program. The case originated from a whistleblower lawsuit, with the whistleblower set to receive approximately $132,000 from the Fromer Eye Centers settlement.
Assistant Attorney General Brett A. Shumate stressed the importance of unbiased medical advice free from illegal influences, stating the DOJ’s commitment to holding healthcare providers accountable. U.S. Attorney Gregory W. Kehoe of the Middle District of Florida highlighted the damage caused when providers prioritize profit over patient care.
The investigation involved collaboration between the DOJ’s Civil Division, the U.S. Attorney’s Office for the Middle District of Florida, the Department of Health and Human Services Office of Inspector General (HHS-OIG), and the FBI. This settlement follows similar actions against other ophthalmology practices accused of comparable fraudulent billing.
The DOJ continues to aggressively combat healthcare fraud through the False Claims Act, recovering billions for taxpayers and protecting federal healthcare programs. The recent launch of the Task Force to Eliminate Fraud and the National Fraud Enforcement Division underscores the government’s dedication to rooting out fraud, waste, and abuse in federal programs.
Representatives from the DOJ noted that the settlement resolves allegations but does not constitute an admission of liability. The case was handled by Trial Attorney Nelson Wagner and Assistant U.S. Attorney Mamie Wise.
For reporting suspected fraud, the public can contact HHS at 1-800-HHS-TIPS (800-447-8477).
