JACKSONVILLE, Fla. — A Fleming Island-based eye care business, Clay Eye Holdings LLC, will pay $2.1 million to resolve allegations that it submitted fraudulent claims to Medicare and Medicaid. These claims reportedly involved unnecessary ultrasound procedures, as reported by the U.S. Justice Department.

The settlement comes as part of a broader agreement involving five ophthalmology practices across Florida, which together are paying nearly $6 million. This settlement stems from a whistleblower lawsuit that accused these practices of violating the federal False Claims Act. The announcement was made on January 15 by the U.S. Attorney’s Office for Florida’s Middle District, which includes the Jacksonville area.

The False Claims Act, a law originating from the 19th century, is frequently used to address business practices that involve kickbacks, which can inflate government expenses for programs like Medicare, the healthcare service for seniors in the United States.

“Kickbacks and false claims drive up healthcare costs for all Americans and compromise the integrity of healthcare decision-making,” stated Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division in the official release.

The federal courts’ Pacer system for tracking legal cases didn’t list any cases involving Clay Eye Holdings, however.

The Justice Department announcement said the eye-care firms’ payments resolved issues “arising from their billing for trans-cranial doppler ultrasounds (TCDs) through a kickback arrangement” with an unnamed third-party testing company.

“… The United States alleged that as a result of this scheme, the settling practices submitted … false claims to Medicare and Medicaid for TCDs … that were medically unnecessary, [and] that were premised on false diagnoses,” the Justice release said.

Trans-cranial doppler ultrasound tests use sound waves to find conditions, like strokes, affecting blood flow in the brain. Some eye-care providers use the test to examine patients with conditions including migraines, blurred or double vision and some types of glaucoma.

But the Justice release suggested concern the test was being used excessively, saying the firms in the settlements “performed TCDs on thousands of patients and billed Medicare and Medicaid hundreds of dollars per test.

“Before the patients received the results of the test, the practices and the third-party testing company identified the patients as having received a serious diagnosis that could qualify the patient for reimbursement of a TCD by Medicare or Medicaid” the release said. “However, nearly all patients who received TCDs never had that diagnosis, and it was not reflected in the patient’s medical history or in the TCD results.”

Editor’s note: This story was first published by our news partners, The Florida Times-Union.