Optometrist Sentenced to 33 Months in Prison For Health Care Fraud Involving At Least $250,000 In Losses
PITTSBURGH – A resident of Hazelet, New Jersey, was sentenced in federal court for engaging in health care fraud, United States Attorney Scott W. Brady announced today.
United States District Judge Cathy Bissoon sentenced Dr. Vincent J. Gamuzza, 31, to serve 33 months’ incarceration and pay a $25,000 fine.
Gamuzza previously pleaded guilty to one count of health care fraud on September 18, 2017. In connection with his guilty plea, Gamuzza, a doctor of optometry, admitted that he operated multiple vision centers in Pennsylvania, including Western Pennsylvania, and in New Jersey. Gamuzza was responsible for handling all billing to insurance companies, including Highmark Inc. and Davis Vision. As part of his guilty plea, Gamuzza admitted that between in or around December 2015 and July 2016, he submitted fraudulent claims to Highmark Inc. for services that were never provided to patients. He also admitted that he impermissibly submitted claims for the same services to both Highmark Inc. and Davis Vision. In total, Gamuzza admitted this his crime involved losses of between $250,000 and $550,000 to insurance providers. At his sentencing hearing, Gamuzza further acknowledged that he attempted to obstruct justice when he submitted fabricated treatment records to the government in an effort to justify his continued fraudulent billing.
Judge Bissoon also ordered Gamuzza to make restitution of $95,667 to Highmark Inc. and $3,333 to Davis Vision.
Assistant United States Attorneys Eric G. Olshan and Robert S. Cessar prosecuted this case on behalf of the government.
The Federal Bureau of Investigation, the United States Department of Health and Human Services – Office of Inspector General, and the Department of Defense – Office of Inspector General conducted the investigation of Gamuzza.