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Maryland Ophthalmologist Agreed to Be Excluded for 20 Years for Submitting Claims for Allegedly Medically Unnecessary Procedures

In connection with the resolution of False Claims Act liability, an ophthalmologist agreed to be excluded from participating in Federal health care programs for a period of twenty years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the ophthalmologist presented or caused to be presented false or fraudulent claims for payment to Medicare and Medicaid for: (1) repeated Argon Laser Trabeculoplasties, a procedure used to treat open angle glaucoma, that were not reasonable and necessary; (2) repeated Lysis of Adhesion, a procedure used to correct a rare complication of cataract surgery, that were not reasonable and necessary; and (3) repeated Laser Peripheral Iridotomies, a procedure used to treat narrow angle glaucoma, that were not reasonable and necessary.

Action Details

  • Date:March 13, 2014
  • Enforcement Types:
    • CMP and Affirmative Exclusions