Optometry is a health care profession that involves examining the eyes. An optometrist generally looks for defects or abnormalities in the eyes of his/her patients. It is the job of an optometrist to prescribe corrective eyewear such as glasses or contact lenses to aid with vision impairments. 76 year-old optometrist, Carole Sachs, however, took her role as an optometrist one step further.
As reported by the Eastern District of California branch of the United States Department of Justice last week, Dr. Sachs has been charged with nine counts of health care fraud. According to the DoJ report, the Delhi, California resident fraudulently billed Medicare for optometry services she did not provide.
Sachs fraudulently billed Medicare over $1 million.
Court documents noted that Sachs practiced out of offices in Turlock and Modesto, California. Between November 2016 and February 2021, she billed over $1 million and received over $700,000 in payments from Medicare from false and fraudulent claims. “The fraudulent claims included claims for performing ultrasounds and for placing amniotic membranes on patients’ eyes despite the fact that Sachs did not perform these procedures,” reports the DoJ.
If convicted, Sachs faces a maximum statutory penalty of 10 years in prison. She also faces a $250,000 fine. “Any sentence, however, would be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables,” the DoJ details, “The charges are only allegations; the defendant is presumed innocent until and unless proven guilty beyond a reasonable doubt.”
Medical provider pleads guilty to health care fraud.
Over in Columbia, South Carolina, another medical professional has entered a guilty plea to his health care fraud charges. 47 year-old Joseph Benjamin Barton has pleaded guilty to a felony count of health care fraud for billing Medicare for $194,000 that was not due. The owner and operator of Midlands Physical Medicine LLC in Richland County, Barton now faces a maximum sentence of ten years of imprisonment, a $250,000 fine and three years of supervised release.
As reported by the District of South Carolina branch of the United States Department of Justice, “evidence presented in court showed that, from June 2016 until February 2017, Barton, through Midlands Physical Medicine, fraudulently submitted false claims to Medicare Part B for implantable neuro-stimulator pulse generators that beneficiaries did not receive and submitted ‘approvals’ for such devices by a doctor no longer affiliated with the practice.”
Barton submitted false claims to Medicare.
He also stated that another affiliated physician rendered the procedure being claimed. However, that physician was not a part of the practice. In fact, he was living in Florida at the time. The doctor was also unaware that Barton submitted these claims using his identifiers as the provider that rendered the services.
“In actuality, a physician’s assistant was providing Medicare beneficiaries an auricular electrical nerve stimulation device not covered by Medicare, in place of an implantable stimulator device, to provide relief from pain and/or headaches,” the DoJ concludes.
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