BRANDON, Fla. — Brandon Eye Associates P.A., a Florida ophthalmology practice with offices in Brandon, Sun City, and Plant City, has agreed to pay $1.3 million to resolve allegations of submitting false claims to Medicare and Medicaid. The settlement addresses violations of the False Claims Act and the Florida False Claims Act related to a kickback scheme involving medically unnecessary trans-cranial Doppler (TCD) ultrasounds.
According to the U.S. Department of Justice, from at least 2016 to 2019, Brandon Eye worked with a third-party provider to offer TCDs to patients diagnosed with common conditions such as diabetes, hypertension, and glaucoma. The practice allegedly misled Medicare and Medicaid by submitting claims for TCDs that were based on false diagnoses of serious health conditions, such as occlusion and stenosis of cerebral arteries. These conditions were typically not present in the patients, making the TCDs unnecessary.
“The payment of kickbacks can bias medical decision making, result in unnecessary services, and drive up health care costs at the expense of the American taxpayers,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s settlement demonstrates that the Justice Department will continue to hold accountable those who enter into kickback arrangements that undermine the integrity of federal health care programs.”
As part of the scheme, Brandon Eye received kickbacks from the third-party provider, based on the volume of TCDs ordered, and referred patients to the provider’s preferred radiology group for the professional component of the test. This practice led to false claims for reimbursement from federal and state healthcare programs.
“We are all victims when the Medicare and Medicaid systems taxpayers fund are cheated,” said Special Agent in Charge Matthew Fodor of the FBI Tampa Field Office. “This is why the FBI vigorously investigates alleged kickback schemes and false billing practices, because it is our mission to protect the American people.”
The settlement includes $1.21 million to be paid to the United States and $89,754 to the state of Florida for its share of Medicaid costs. The Justice Department emphasized the harmful impact of kickback schemes, which can inflate healthcare costs and undermine the integrity of public health programs.
“This settlement sends a clear message that the Justice Department will hold accountable those who exploit federal healthcare programs for financial gain,” said Principal Deputy Assistant Attorney General Brian M. Boynton.
The U.S. Attorney’s Office for the Middle District of Florida, along with the FBI and the Department of Health and Human Services Office of Inspector General, led the investigation into the case. Brandon Eye has also agreed to cooperate with ongoing investigations into other participants in the alleged scheme.
The settlement marks a significant step in the government’s efforts to combat fraud in healthcare billing and protect taxpayers from wasteful practices.
“Kickback arrangements meant to boost company profits can corrupt the legitimate medical decision-making process and undermine the integrity of federal healthcare programs,” said Special Agent in Charge Stephen Mahmood of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG and our law enforcement partners will continue to pursue allegations of improper billing and kickback schemes to protect both Medicare and Medicaid and those served by those programs.”
