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Press Release

Queens and Brooklyn-Based Eye Doctor Settles Health Care Fraud Claims for More Than $2.4 Million

For Immediate Release
U.S. Attorney's Office, Eastern District of New York
Settlement Addresses Allegations that Dr. Sheldon Rabin and His Practice Billed Medicare and Medicaid for Services that Were Medically Unnecessary or Could Not Have Been Performed

Breon Peace, United States Attorney for the Eastern District of New York, Letitia James, New York State Attorney General, and Naomi Gruchacz, Special Agent-in-Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), announced today a settlement agreement with a New York-based ophthalmologist, his ophthalmology practice and related entities which allegedly provided ophthalmological health care services to Brooklyn and Queens residents, many of whom were elderly or non-native English speakers.  The settlement agreement requires the defendants to pay more than $2.4 million to resolve claims that they billed or caused to be billed false claims for payment to Medicare and Medicaid for certain procedures, tests, and other ophthalmological services that were either unnecessary or could not have been performed because the ophthalmologist was not in his office. Under the terms of the agreement, these providers, including Sheldon Rabin, Sheldon Rabin, M.D., Sheldon Rabin, M.D., P.C. d/b/a New York Eye Care, will pay $2,426,144.93 to the United States to resolve claims under the False Claims Act.  The defendants have also separately agreed to pay $73,855.07 to New York State to resolve claims under New York State’s False Claims Act, for a total payment of $2.5 million.  

“As alleged, the defendants took advantage of our district's older residents and other vulnerable individuals in defrauding the Medicare and Medicaid programs for their own personal gain,” stated U.S. Attorney Peace.  “As this settlement makes clear, our Office will protect the integrity of government health care programs and pursue providers who enrich themselves through fraud.”

Mr. Peace also thanked the Medicaid Fraud Control Unit of the Office of the New York State Attorney General for their assistance with the investigation.

“Doctors who exploit their patients undermine the health care system that all New Yorkers rely on,” stated New York Attorney General James.  “Dr. Rabin and his practice unjustly enriched themselves with taxpayer funds by taking advantage of their elderly and vulnerable patients, and today they are being held accountable. I thank U.S. Attorney Peace and our partners in this investigation for bringing this case to ensure New Yorkers get the high-quality care they deserve.”

“The Medicare and Medicaid fraud claims in this case involved services that were not medically necessary, which always raises a concern about potential patient harm,” stated HHS-OIG Special Agent-in-Charge Gruchacz.  “Individuals and entities that participate in the federal health care system are required to obey the laws meant to preserve the integrity of program funds and the provision of appropriate, quality services to patients.”

As alleged by the Government, from 2013 through 2016, defendants improperly submitted claims to Medicare and Medicaid for treatments that were unnecessary by manipulating patient test readings to create an appearance of a need for certain eye care services, when in fact, the patients’ test readings indicated no such need. Further, during this same time frame, the government alleged instances of services having been billed, but never actually rendered by Dr. Rabin, because he was out of the office or out of the country when the services were purportedly rendered.

The settlement includes the resolution of two civil actions brought under the qui tam or whistleblower provisions of the False Claims Act. Under the qui tam provisions of the False Claims Act, a private party can file an action on behalf of the United States and receive a portion of the settlement if the government takes over the case and reaches a monetary agreement with the defendant. As alleged in the qui tam actions, the defendants provided ophthalmological health care services to Brooklyn and Queens residents, many of whom were elderly or non-native English speakers.

The claims resolved by the settlement are allegations only and there has been no determination of liability.

The government’s case was handled by Assistant United States Attorney Artemis Lekakis of the Office’s Civil Division.


E.D.N.Y. Docket Nos. 13-CV-1930 (HG) and 15-CV-6356 (HG)

Contact

John Marzulli
Danielle Blustein Hass
U.S. Attorney's Office
(718) 254-6323

Updated June 6, 2024

Topic
Health Care Fraud