New York-Based Eye Doctor Who Unnecessarily Billed Medicare/Medicaid Patients Has Agreed to Pay Nearly $2.5M in Settlement
A recent settlement acknowledges the healthcare fraud allegations made against a New York-based ophthalmologist, Dr. Sheldon Rabin, and his practice. According to a press release issued by the Eastern District of New York and U.S. Department of Health and Human Services, Rabin and his related entities have agreed to pay nearly $2.5 million to resolve claims of fraudulent billing practices involving Medicare and Medicaid.
The settlement addresses claims that Dr. Rabin and his practice allegedly billed for ophthalmological services that were either medically unnecessary or could not have been performed because Rabin was not present in his office. The settlement agreement includes a payment of over $2.4 million to the United States under the False Claims Act and an additional $73,800 to New York State under its False Claims Act, totaling around $2.5 million.
“As alleged, the defendants took advantage of our district’s older residents and other vulnerable individuals in defrauding the Medicare and Medicaid programs for their own personal gain,” stated the U.S. Attorney of the Eastern District of New York. “As this settlement makes clear, our Office will protect the integrity of government health care programs and pursue providers who enrich themselves through fraud.”
The investigation, which received assistance from the Medicaid Fraud Control Unit of the Office of the New York State Attorney General, first revealed the details about the fraudulent practices. From 2013 through 2016, Dr. Rabin and his practice allegedly submitted claims for unnecessary treatments by manipulating patient test readings to fabricate a need for certain eye care services. In many cases, these services were billed but never actually provided, as Dr. Rabin was reportedly out of the office or even out of the country at the time.
In the press release, the HHS-OIG Special Agent-in-Charge stated that this case involved “services that were not medically necessary, which always raises a concern about potential patient harm” and stressed that “[i]ndividuals and entities that participate in the federal health care system are required to obey the laws meant to preserve the integrity of program funds and the provision of appropriate, quality services to patients.”
This case is just one of the many ongoing efforts by federal and state authorities to combat healthcare fraud and protect vulnerable demographics. The resolution of these allegations are a reminder that fraudulent actions will not be tolerated.
If you have any information relating to possible healthcare fraud and would like to speak to an experienced member of the Constantine Cannon whistleblower lawyer team, please do not hesitate to contact us for a free and confidential consultation.