Commonwealth Journal

News Live

May 16, 2013

Optometrist, Associates in Eye Care face fraud charges in federal suit

Somerset —

A local optometrist is facing allegations that he submitted hundreds of fraudulent claims for Medicare and Medicaid payments over a six-year period.
Dr. Phillip Robinson and employer Associates in Eye Care P.S.C. — which has offices in seven cities in both south-central Kentucky and Tennessee, including Somerset (according to their website, www.seemuchbetter.com) — are listed as defendants in a complaint filed in U.S. District Court, Eastern District, by Kerry Harvey, a United States Attorney.
The complaint — dated May 13, 2013 — states that from January 2007 through January 2012, Robinson “provided, or claimed to provide eye examinations and other optometric services to Medicare and Kentucky Medicaid beneficiaries residing in nursing homes” in the eastern part of Kentucky. The lawsuit also states that Associates in Eye Care (AEC) submitted those claims for payment “for Robinson’s actual or alleged optometric services.”
The complaint alleges that “(i)rrespective of condition or diagnosis, Robinson provided eye examinations to most of his nursing home patients on a monthly basis, a frequency that was unreasonable and unnecessary given the patients’ medical conditions.”
Robinson is alleged to have performed an excessively high volume of exams to nursing home patients — more than 50 a day — and on at least 11 different occasions, 100 or more Medicare and Kentucky Medicaid patients in a single day, according to Harvey’s claims.
“To the extent they were actually performed, these eye examinations were so cursory that they failed to provide the level of service necessary to justify Robinson and AEC’s claims to Medicare and Kentucky Medicaid,” reads the complaint. “ ... These claims were false or fraudulent in that they requested payment for optometric services that were not medically reasonable or necessary, and/or claimed reimbursement for a level or type of optometric service that was not actually provided.”
Robinson was allegedly the optometrist at AEC that did this “with limited exception,” increasing his examinations in 2007. The complaint compares these numbers to those Robinson allegedly maintained the year before: in 2006, Robinson billed Medicare (via AEC) for 152 services moderate complexity (typically about 25 minutes long) and seven of low complexity (typically about 15 minutes, for $7,210.75 in reimbursements, part of a Medicare total for the year of over $9,574.

Text Only
News Live
News Live
AP Video
Captain of Sunken SKorean Ferry Arrested Raw: Fire Destroys 3 N.J. Beachfront Homes Raw: Pope Presides Over Good Friday Mass Raw: Space X Launches to Space Station Superheroes Descend on Capitol Mall Man Charged in Kansas City Highway Shootings Obama Awards Navy Football Trophy Anti-semitic Leaflets Posted in Eastern Ukraine Raw: Magnitude-7.2 Earthquake Shakes Mexico City Ceremony at MIT Remembers One of Boston's Finest Raw: Students Hurt in Colo. School Bus Crash Raw: Church Tries for Record With Chalk Jesus Raw: Faithful Celebrate Good Friday Worldwide Deadly Avalanche Sweeps Slopes of Mount Everest Police Arrest Suspect in Highway Shootings Drought Concerns May Hurt Lake Tourism Vermont Goat Meat Gives Refugees Taste of Home Calif. Investigators Re-construct Fatal Bus Cras Mayor Rob Ford Launches Re-election Campaign Appellate Court Hears Okla. Gay Marriage Case
Hyperlocal Search
Premier Guide
Find a business

Walking Fingers
Maps, Menus, Store hours, Coupons, and more...
Premier Guide
Stocks