Ophthalmology Biller Pleads Guilty to Healthcare Fraud and Conspiring to Defraud the Internal Revenue Service
PORTLAND, Ore. – The former practice manager for Eye Care Services, Inc. appeared in federal court yesterday and admitted to his role in defrauding Medicare and other public and private health care plans and conspiring to defraud the Internal Revenue Service (IRS). Anthony Curtis Neal, 40, pled guilty to health care fraud and conspiracy to defraud the IRS before U.S. District Judge Robert E. Jones and admitted that he, along with his deceased father, Dr. Dean Neal, committed health care fraud and tax related crimes between 2007 and 2014. According to the plea agreement, the government will be seeking a sentence of imprisonment and restitution to Medicare, private insurers and the IRS. The actual sentence will be determined by Judge Jones at Anthony Neal’s sentencing hearing which is scheduled for January 4, 2017.
Court records indicate that Anthony Neal worked as the practice manager for Eye Care Services Inc., dba 20/20 Eye Care, an ophthalmology clinic located at 500 NW 20th Suite 100, Gresham, Oregon. Neal worked in conjunction with his father, Dr. Dean Neal, the long-time primary doctor at Eye Care Services (ECS). In addition to serving as the practice manager, Neal was primarily responsible for the insurance billing services. He, along with his father, managed the practice, established testing protocols for patients, and set all business related polices.
Anthony Neal admitted the health care fraud scheme involved three false and fraudulent components: billings for medically unnecessary tests, up-coded billings, and double billings. To increase income, ECS required that many patients receive a battery of diagnostic tests, many of which were not medical necessity. Claims for these medically unnecessary tests were submitted to Medicare and private insurers for reimbursement. Neal also engaged in a practice of up-coding certain tests by claiming ECS was entitled to a higher than warranted reimbursement rate. Finally, ECS was supposed to be paid one amount for tests performed on both eyes, but it fraudulently submitted bills to health insurance plans that resulted in ECS being paid twice, once for each eye. The government alleges the loss attributable to the health care fraud scheme is $1,702,567.89.
As to the conspiracy to defraud the IRS, Anthony Neal admitted to conspiring to conceal ECS income from the IRS and he failed to report business or personal income to the IRS for tax years 2006 – 2013. The government alleges the loss attributable to the tax conspiracy scheme is $817,378.77.
The case was investigated by the U.S. Department of Health and Human Services - Office of Inspector General, the FBI, and the Internal Revenue Service – Criminal Investigation. The case is being prosecuted by Assistant U.S. Attorneys Donna Brecker Maddux and Seth Uram.