Most physicians wouldn’t fall for, “psst, wanna buy a watch?”, but more than you’d probably imagine fall for the opportunity to make some “extra revenue”.
Usually, those opportunities are packaged as something simple. “It’s easy.” “Everyone is doing it.” “We’ll handle the paperwork.” “It’s compliant; our lawyers checked it out.”
Then, years later, someone blows the whistle and, well, it could be time to go to your room without dinner.
On January 15, 2026, the DOJ announced that five Florida ophthalmology practices agreed to pay nearly $6 million to resolve False Claims Act allegations tied to billing trans-cranial doppler ultrasounds (TCDs) through what the government described as a kickback arrangement with a third-party testing company.
Here’s the breakdown of the settlement: Clay Eye Holdings LLC will pay $2,140,000, Retina Macula Specialist of Miami LLC will pay $1,750,000, Florida Eye Institute P.A. will pay $1,250,000, Miami Eye LLC will pay $525,000, and Kendall Eye Institute Inc. will pay $310,000.
According to the government’s allegations, the practices performed thousands of TCDs and billed Medicare and Medicaid hundreds of dollars per test, despite the tests allegedly being medically unnecessary and, in many cases, premised on diagnoses that were not supported by the patients’ medical histories or the test results.
Additionally, the government alleged that settling practices paid the third-party testing company based on the volume or value of tests ordered and referred the patients to the testing company’s preferred radiology group for the TCDs’ professional component.
In addition to the payment of settlement dollars, all five practices agreed to cooperate with the Justice Department’s ongoing investigations of other participants in the alleged scheme. And, as to “other participants”, the federal government previously resolved similar allegations against two other ophthalmology practices, Brandon Eye Associates P.A., and Pinellas Eye Care, P.A. dba Gulfcoast Eye Care.
Note that in the case of all civil settlements, the claims resolved are allegations only and there was no determination of liability.
Some takeaways for you:
- Easy money in the context of medical practice can often be like eating that questionable burrito: tasty on the way down, ptomaine on the way up.
- “No one on the outside is going to find out” really means that it’s likely that someone on the inside, a whistleblower, knows exactly what’s going on. Here, in the case of the five eyes, the whistleblower who filed the original False Claims Act lawsuit is to walk away with more than $1.13 million.
- Like a bad game of “the prisoners’ dilemma”, when a scam ship begins to sink, the pressure is on to settle out for reasonable bucks and the obligation to sing for the rest of your supper.
