Former Owner of R.I. Ophthalmology Chain Pays $1.1 Million to Settle Charges of FCA Violations alleging Kickbacks and Medicare Fraud in Lawsuit Filed by Herman Law Group
Providence, Rhode Island (PRWEB) April 24, 2023 -- Dr. Paul S. Koch, a retired ophthalmologist has agreed to pay over $1.16 million dollars to resolve alleged claims that he, through Koch Eye Associates and Claris Vision paid kickback to optometrists who referred cataract surgery patients. The lawsuit was filed by Rhode Island attorneys, Louise A. Herman, Herman Law Group and Andrew Berg, Sammartino & Berg, LLP.
The settlement resolves allegations that Dr. Koch, through Koch Eye Associates, LLP and Claris Vision, LLC systematically paid kickbacks to optometrists through the use of sham co-management agreements in exchange for cataract surgery referrals that were billed to Medicare in violation of the Anti-Kickback Statute and the False Claims Act (“FCA”).
The settlement is neither an admission of liability by Dr. Koch nor a concession by the government that their claims were not well founded. The case remained under seal for several years while the Government investigated, and eventually settled with Dr. Koch.
The FCA allows private citizens with knowledge of fraud against a government program to file lawsuits on the government’s behalf. If the case is successful, the private plaintiffs, known as “relators,” are entitled to a percentage of the government’s recovery. The FCA provides for recovery of treble (triple) the single damages incurred by the government as a result of the fraud, as well as civil monetary penalties of up to $27,018 per false claim submitted and statutory attorney fees. In this case, under the terms of the Settlement Agreement, the two whistleblowers, will receive a total of $256,535 (22%) from the United States government for initiating the lawsuit and prompting the government’s investigation.
Herman praised her clients’ courage in exposing this kickback scheme, adding: "It takes bravery to expose a fraud scheme perpetrated by powerful interests, and we applaud our clients for stepping forward and speaking up against corruption.” Berg notes “The FCA is a ‘win-win’ for both the Government and concerned citizens. In this regard the FCA is an effective mechanism for the Government to recoup ill-begotten funds, and as was the case here, the law compensates employees for the significant retaliation they often suffer when reporting the wrongdoing of the perpetrator.
Herman and Berg commended AUSA Bethany Wong and AUSA Dulce Donovan of the U.S. Attorney's Office in Rhode Island and Special Agent Lindsay Walford, HHS-OIG, for their outstanding work on the case. “The government team at the Rhode Island United States Attorney's Office have done a tremendous job investigating this case and in recovering over a million dollars in taxpayer funds.”
The case is captioned, United States of America, et al. v. Claris Vision, LLC et al., Case Number 18-176, United States District Court, District of Rhode Island.
A copy of the USDOJ press release is available at https://www.justice.gov/usao-ri/pr/former-owner-ri-ophthalmology-chain-pay-11m-settlement-false-claims-inquiry-united-states.
For additional information, please contact Louise A. Herman, Esq. of Herman Law Group at (401) 277-4110 ([email protected]) or Andrew Berg, Esq. of Sammartino and Berg at (401) 274-0113 ([email protected]).
Louise A Herman, Esq., Herman Law Group, https://www.lhermanlaw.com/, 1 401-277-4110, [email protected]
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