Louisiana Settles False Claims Act with Optometrist’s Office

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Two People Shaking Hands after False Claims Act Victory, representing Elder Care Fraud

On November 18, 2013, the Department of Justice announced a settlement with Sabine Optical, an optometry office located in Baton Rouge, Louisiana, based on allegations of Medicaid fraud.  According to the details of the case, Sabine Optical (“Sabine”) which does business as The Vision Center, engaged in a pattern of billing behavior designed to garner illegal U.S. and Louisiana Medicaid payments.

False Claims Act Lawsuit Exposes Fraud

The qui tam lawsuit, filed under the False Claims Act, was brought by whistleblower and former Sabine employee William Y. Guess.  Mr. Guess claims that Sabine employed a number of traditional fraud schemes, commonly seen in False Claims Act cases.  Mr. Guess alleges that the tactics ran the gamut, from billing Medicaid for procedures that were never performed to falsification of Medicaid patients’ prior authorization forms.  Mr. Guess also contends that Sabine routinely billed Medicaid using another provider’s Medicaid number.

The case was filed under both the Federal False Claims Act and its Louisiana counterpart, demonstrating once again the value of individual states’ false claims laws.  Pursuant to the settlement, Sabine will pay $1.2 million in damages, $819,960.00 to the U.S. and $380,040.00 to Louisiana.  For his efforts, Mr. Guess will receive twenty percent of the total recovery.