Two San Diego eye doctors pay $950,000 to settle billing fraud allegations

Seal of the United States Attorney’s Office for the Southern District of California. Photo via Twitter @SDCAnews.

Two San Diego eye doctors have paid nearly $950,000 to resolve allegations that they submitted false claims to Medicare for treatment provided by a doctor who was not properly credentialed, the U.S. attorney’s office said Thursday.

Mark D. Smith and Fane Robinson of San Diego Retina Associates violated the False Claims Act by submitting claims that falsely identified which doctor treated the patients, federal prosecutors said. The U.S. attorney’s office said the attending physician was not properly licensed at the time to treat Medicare patients.

The settlement ends a lawsuit filed last year by eye doctor and former San Diego Retina Associates partner Atul Jain, who will receive about $170,000 from the proceeds, prosecutors said. Jain filed the lawsuit under the whistleblower provision of the False Claims Act, according to the U.S. Attorney’s Office.

“False billing to circumvent Medicare’s oversight of physicians negatively impacts taxpayers and puts patient health at risk,” U.S. Attorney Robert Brewer said. “We commend the whistleblower in this case, Dr. Jain, for coming forward and working with investigators.”

— City News Service

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