Florida eye practice and its owner to pay $350,000 over false Medicare claims
St. Michael's Eye & Laser Institute and Dr. John Michaelos agreed to settle allegations that they steered patients to a diagnostic company for brain blood-flow tests in exchange for payments, the U.S. attorney's office in Boston said.
A Florida ophthalmology practice and its owner have agreed to pay $350,000 to settle allegations that they caused false claims to be submitted to Medicare, the U.S. attorney's office in Boston said Friday.
Prosecutors said St. Michael's Eye & Laser Institute and Dr. John Michaelos, an ophthalmologist who owns the practice, caused false claims for transcranial doppler tests to be sent to Medicare and the Veterans Health Administration from September 2015 through December 2020. The test uses high-frequency sound waves to estimate blood flow through certain vessels in the brain.
According to the U.S. attorney's office, the practice had contracts with an independent diagnostics company, Eyecuity PLLC, that called for payments based on the cost of office space, staff and utilities. Instead, prosecutors said, Eyecuity paid St. Michael's for the patients it referred for the tests, an arrangement the government said violated the federal Anti-Kickback Statute and rendered the resulting claims false.
Prosecutors also said that when Eyecuity billed Medicare, it documented the tests as medically necessary by indicating patients had vertebrobasilar insufficiency, a very rare condition, even though doctors at St. Michael's had no reason to believe patients had that diagnosis.
As part of the settlement, the practice and Michaelos admitted and accepted responsibility for the facts underlying the agreement, the U.S. attorney's office said.
The case was announced by U.S. Attorney Leah B. Foley and the Department of Health and Human Services' Office of Inspector General.
This brief was drafted by AI from a public agency press release and published by The New England Signal. Why we use AI for stories like this one.