AG Tong Announces False Claims Settlement With Optician Your Eyes of New Britain
(Hartford, CT) – Attorney General William Tong today announced a $263,488 civil False Claims Act settlement with Your Eyes of New Britain regarding overbilling for eyeglass refitting. Your Eyes of New Britain provides vision care services including the design, manufacture, fitting, and dispensing of prescription eyeglasses.
A joint state/federal investigation found that during the time period from January 1, 2014 until April 30, 2019 Your Eyes of New Britain routinely doubled-billed the Connecticut Medicaid Program for eyeglass fittings. Specifically, when a Medicaid patient purchased new eyeglasses, Your Eyes billed Medicaid for the eyeglasses, which included the initial fitting. When the eyeglasses were ready for pick-up, Your Eyes billed Medicaid a second time for any subsequent final adjustments necessary as if the service was a separate “repair and refitting,” which is against Medicaid policy. Investigators found that Your Eyes falsely billed Medicaid 26,615 times, resulting in overpayments of $175,659.
“Healthcare providers in the state Medicaid program have a legal obligation to make sure their billings are true and accurate. Your Eyes of New Britain submitted thousands of improper claims over a period of four years, taking in Medicaid payments they were not entitled to. This settlement makes taxpayers whole and sends an important message that Connecticut will take aggressive action to safeguard our public healthcare programs,” said Attorney General Tong.
“This False Claims Act settlement indicates the constant need to protect the fiscal integrity of the Medicaid program from outlier providers who violate the public trust. While this case does not exemplify our dedicated providers as a whole, the skilled investigators and attorneys who rooted it out and obtained the financial settlement are commended for their outstanding work. I join Attorney General Tong in thanking all of our state and federal partners,” said DSS Commissioner Deidre S. Gifford of the Department of Social Services (DSS), administering agency for Medicaid.
The joint state/federal investigation was conducted by the Office of the Attorney General; the United States Attorney's Office, District of Connecticut; and the United States Department of Health and Human Services, Office of the Inspector General, Office of Investigations. The Medicaid Fraud Control Unit in the Office of the Chief State's Attorney also assisted with the investigation following a fraud referral from the DSS Office of Quality Assurance's Special Investigations Unit. Attorney General Tong thanked all involved in the joint investigation for the considerable assistance they provided.
Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Attorney General’s Antitrust and Government Program Fraud Department at 860-808-5040 or by email at firstname.lastname@example.org; the Medicaid Fraud Control Unit at 860-258-5986 or by email at email@example.com; or the Department of Social Services fraud reporting hotline at 1-800-842-2155, online at www.ct.gov/dss/reportingfraud, or by email to firstname.lastname@example.org.
Legal Investigators Timothy Edwards and Lisa Bailey, and Assistant Attorneys General Gregory K. O’Connell and Michael E. Cole, Chief of the Antitrust and Government Program Fraud Department, assisted the Attorney General with this matter.