Eye Practice and Physician Owner Agree to Pay $415,000 to Resolve Allegations of False Claims Act to Medicare

BOSTON - The Mitchell Eye Center, a Florida ophthalmology practice, and Dr. Alan Mitchell, an ophthalmologist and former owner of the Mitchell Eye Center, have agreed to pay $415,000 to resolve allegations that they caused the submission of false claims to Medicare in violation of the False Claims Act.

The United States alleges that from September 2018 through March 2020, Mitchell Eye Center and Dr. Mitchell caused the submission of false claims for transcranial doppler (TCD) tests to Medicare and the Veterans Health Administration. A TCD test is a non-invasive diagnostic test that can be used to estimate the blood flow through certain blood vessels in the brain by bouncing high-frequency sound waves off blood cells. As part of the settlement agreement, the Mitchell Eye Center and Dr. Mitchell admitted to and accepted responsibility for facts underlying the settlement agreement. Mitchell Eye Center had contractual agreements with an independent medical diagnostics company, Eyecuity, PLLC (Eyecuity). During the relevant time, Eyecuity paid Mitchell Eye Center for every referral that the Mitchell Eye Center made for TCD tests, even though the parties' contracts called for payment based on fair market value of rent and administrative services rendered, and not per-patient or per-test that Mitchell Eye Center referred to Eyecuity. When documenting the purported medical necessity of the TCD tests for Medicare to cover the costs of the tests, Mitchell Eye Center physicians also signed order forms that Eyecuity had provided, indicating that patients had Vertebro-Basilar Syndrome or Vertebrobasilar Insufficiency (VBI), a very rare condition. But Mitchell Eye Center physicians did not have reason to believe that patients had a diagnosis of VBI.

The United States contends that the claims for the TCD tests that Mitchell Eye Center and Dr. Mitchell caused Eyecuity to submit to Medicare were false because the TCD tests were not medically necessary and because the Mitchell Eye Center received payments from Eyecuity that violated the Anti-Kickback Statute.

United States Attorney Leah B. Foley and Roberto Coviello, Special Agent in Charge, Health and Human Services-Office of Inspector General made the announcement today. The Department of Veterans Affairs, Office of Inspector General provided valuable assistance. Assistant U.S. Attorney Charles B. Weinograd of the U.S. Attorney's Office's Affirmative Civil Enforcement Unit is handling this case.