Nursing home optometrist faces False Claims suit alleging excessive, unreasonable eye exams

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An optometrist in Kentucky defrauded Medicare and Medicaid by filing claims for nursing home care that was unnecessary or not provided, alleges a False Claims Act lawsuit recently brought by the federal government.

The defendant, Philip Robinson, O.D., filed more Medicare and Medicaid claims than any other optometrist in the nation during a six-month period in 2008, according to the complaint. He sought reimbursement for treating as many as 100 nursing home residents in a single day, and he provided eye exams that were “unnecessary and unreasonable” given the residents' health status, the suit states.

“Individuals paying for eye care with money from their own pocket would not be expected to pay a doctor to simply monitor their vision with a monthly exam, especially if the exams were as brief and superficial as what Robinson provided,” said Kerry B. Harvey, U.S. attorney for the Eastern District of Kentucky.

Robinson and his practice group, Associates in Eye Care, P.S.C., face penalties of between $5,500 and $11,000 per false claim. The government is also seeking reimbursements for Medicare and Medicaid payouts, but did not specify an amount in the complaint.

Robinson filed so many claims because he was the only optometrist serving nursing homes in 10 counties, and many of his patients required close monitoring, defense attorney Jennifer L. Wintergerst told local reporters.

The lawsuit follows an investigation of Robinson launched by the Department of Health and Human Services Office of Inspector General and the Kentucky Attorney General's Medicaid Fraud and Abuse Unit.