Fromer Eye Centers Settles $2.3 Million Healthcare Fraud Allegations
Mark D. Fromer, P.C., operating as Fromer Eye Centers, along with Floral Park Ophthalmology P.C. in New York, has agreed to pay $2.3 million to settle allegations related to violations of the False Claims Act. The claims involve an improper billing scheme for trans-cranial doppler ultrasounds (TCDs) executed under an incentivized agreement with a third-party company. The settlement also involves the Estate of Mark Fromer, the former owner of the eye centers, with both practices agreeing to cooperate with the Department of Justice's ongoing investigations.
Assistant Attorney General Brett A. Shumate highlighted the importance of keeping healthcare decisions free from illegal kickbacks and improper arrangements. U.S. Attorney Gregory W. Kehoe underscored that prioritizing profit over patient care compromises the healthcare system, pledging continued efforts to combat fraud that affects federal programs. Special Agent Isaac M. Bledsoe from the Department of Health and Human Services Office of Inspector General (HHS-OIG) commented on how kickback schemes influence medical decision-making and inflate healthcare costs.
The settlements address allegations of submitting false claims to Medicare and Medicaid for unnecessary TCDs. These practices allegedly involved misrepresenting patient diagnoses to justify billing for these tests, despite the absence of valid medical conditions. It is claimed that Floral Park Ophthalmology received financial incentives from the testing company to promote patient referrals specifically for TCDs.
Under the settlement terms, Fromer Eye Centers and Mark Fromer's estate will pay $1.8 million, while Floral Park Ophthalmology will contribute $500,000. The State of New York will receive $384,000 of this settlement for its Medicaid program. The case was filed under the qui tam provision of the False Claims Act by a whistleblower who will receive approximately $132,000 as part of the settlement with Fromer Eye Centers.
These settlements are part of a joint effort by the Civil Division’s Commercial Litigation Branch, the U.S. Attorney’s Office for the Middle District of Florida, HHS-OIG, and the FBI. The case follows similar resolutions involving other eye care providers in Florida, showcasing the government’s resolve in combating healthcare fraud through the False Claims Act.
The Department of Justice continues its initiatives, such as the Task Force to Eliminate Fraud and the National Fraud Enforcement Division, to address healthcare fraud and safeguard the integrity of federal programs. It is noteworthy that the resolved claims through this settlement remain allegations, without an adjudicated finding of liability.