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Somerset eye doctor filed false claims

A Pulaski County-based optometrist was found liable for providing more than 11,000 unnecessary eye examinations to patients in nursing homes in Pulaski, McCreary and Lincoln Counties.

A federal jury found Dr. Phillip Robinson liable for billing the Medicare program more than $419,000 between 2007 and 2012 in a civil case presented by the United States Attorney’s Office.

The trial, lasting five days, contended Dr. Robinson provided eye examinations to the vast majority of nursing home patients on a weekly basis in more than a dozen facilities over the five-year period.

Prosecutors charged that the doctor gave examinations some times as often as once a week, regardless of the need or condition of the patients. Testimony from medical experts stated they were unaware of any other optometrists who provided the exams with the same frequency.

It was shown the doctor intentionally billed Medicare for the exams, which is only to be used for medically necessary exams, in effect filing false claims.

Dr. Robinson was found liable under the False Claims Act and will be required to pay back the federal government three times the amount billed, totaling more than $1,250,000.

“Dr. Robinson’s scheme to defraud the taxpayers betrays the standards we expect of our healthcare providers,” said U.S. Attorney Kerry B. Harvey. “His willingness to use many of our most vulnerable citizens to further his financial interests at the expense of our vital federally funded healthcare programs is particularly troubling. We will continue to use every available tool to protect the public treasury from this sort of abuse.”

According to the U.S. Attorney’s Office Dr. Robinson’s practice group, Associates in Eye Care, agreed to pay the government $800,000 in January to settle related claims against it, thereby avoiding trial.

Health care providers found liable under the False Claims Act are typically excluded from further participation in federal health care programs such as Medicare and Medicaid. A decision about Dr. Robinson’s exclusion from federal health care programs will be made by the Department for Health and Human Services, Office of Inspector General (HHS-OIG).

This investigation was conducted by HHS-OIG, the Kentucky Office of

Attorney General’s Medicaid Fraud and Abuse Control Unit, and the United States Attorney’s Office for the Eastern District of Kentucky. Assistant United States Attorneys Christine Corndorf, Andrew Smith, and Paul McCaffrey litigated the case on behalf of the federal government.

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