Somerset Optometrist Found Liable for False Claims Act
LEXINGTON - The U.S. Attorney’s Office announced today that a federal jury found Dr. Phillip Robinson, a Somerset optometrist, liable, under the False Claims Act, for seeking payment from the Medicare program for more than 11,000 unnecessary eye examinations he provided to nursing home residents.
On Friday, May 1, 2015, the jury reached its verdict, after three hours of deliberation, following a five-day trial. The jury found that the Medicare program lost $419,075 as a result of Dr. Robinson’s false claims. Under the False Claims Act, Dr. Robinson will be required to pay the federal government three times that amount, $1,257,225.
“Dr. Robinson's scheme to defraud the taxpayers betrays the standards we expect of our healthcare providers,” said U.S. Attorney Kerry B. Harvey. “His willingness to use many of our most vulnerable citizens to further his financial interests at the expense of our vital federally funded healthcare programs is particularly troubling. We will continue to use every available tool to protect the public treasury from this sort of abuse.”
Dr. Robinson provided eye care services at approximately a dozen nursing homes in Pulaski, Lincoln, and McCreary Counties, among other southeastern and south-central locations in Kentucky. Evidence presented at the trial established that, from January 1, 2007 to January 31, 2012, Dr. Robinson gave eye examinations to the vast majority of his nursing home patients, once a month, regardless of the patients’ condition or medical need. Medical experts testified that they were unaware of any other optometrists that provided eye exams with this frequency.
The evidence further established that Dr. Robinson caused the Medicare program to be billed for these exams. Because Medicare only pays for medically necessary exams, Dr. Robinson intentionally filed claims that represented each exam was necessary.
The jury concluded that Dr. Robinson was responsible for 11,085 false claims, submitted to Medicare for payment, for the unnecessary eye examinations.
In January 2015, Dr. Robinson’s practice group, Associates in Eye Care, agreed to pay the government $800,000 to settle related claims against it, thereby avoiding trial.
Health care providers found liable under the False Claims Act are typically excluded from further participation in federal health care programs such as Medicare and Medicaid. A decision about Dr. Robinson’s exclusion from federal health care programs will be made by the Department for Health and Human Services, Office of Inspector General (HHS-OIG).
This investigation was conducted by HHS-OIG, the Kentucky Office of Attorney General’s Medicaid Fraud and Abuse Control Unit, and the United States Attorney’s Office for the Eastern District of Kentucky. Assistant United States Attorneys Christine Corndorf, Andrew Smith, and Paul McCaffrey litigated the case on behalf of the federal government.