United States Attorney Gregory W. Kehoe announces that Pinellas Eye Care, PA d/b/a Gulfcoast Eye Care, an ophthalmology practice with offices in Pinellas Park, Palm Harbor, and St. Petersburg, Florida, has agreed to pay $615,000 to resolve alleged violations of the False Claims Act and an analogous Florida statute arising from its billing for trans-cranial doppler ultrasounds (“TCDs”) provided through a kickback arrangement with a third party. Gulfcoast Eye has agreed to cooperate with the Justice Department’s ongoing investigations of other participants in the alleged scheme. The settlement resolves allegations that Gulfcoast Eye knowingly submitted, and caused the submission of, false claims to Medicare and Medicaid for medically unnecessary TCDs.
Gulfcoast Eye and a third-party provider of TCD services performed TCDs on thousands of patients and billed Medicare and Medicaid hundreds of dollars per test. Before the patients received the results of the test, Gulfcoast Eye and the third-party provider identified the patients as having received a serious diagnosis—most commonly of occlusion and stenosis of their cerebral arteries—that could qualify the patient for reimbursement of a TCD by Medicare or Medicaid. However, nearly all patients who received TCDs never had occlusion and stenosis of cerebral arteries, and that diagnosis was accordingly not reflected in the patient’s medical history or in the TCD results. Gulfcoast Eye paid the third-party TCD provider based on the volume or value of tests ordered and referred the patients to the TCD provider’s preferred radiology group for the TCD’s professional component.