BRUNSWICK — A Brunswick eye doctor’s office agreed to pay $16,343 in a civil settlement with federal prosecutors.
Brunswick Eye Care Associates entered into an agreement with the U.S. Attorney’s Office in Maine and the state of Maine in an effort to resolve allegations that the business submitted false claims to Medicare, TRICARE, The Department of Veterans Affairs and MaineCare from May 7, 2014, through April 29, 2016.
MaineCare, Maine’s Medicaid program, is primarily funded with federal money. The U.S. government pays roughly two-thirds of all claims submitted to MaineCare, according to a news release issued by Acting U.S. Attorney Richard W. Murphy.
The office billed and received reimbursement from Medicare, TRICARE, Veterans Affairs and MaineCare for services it provided, but then improperly used a portion of the money received from those government programs to pay the salary and benefits of an office employee who had previously been excluded from federal health care programs and MaineCare, according to a civil complaint filed Monday at U.S. District Court in Portland.
Before joining the Brunswick office, that worker was blocked because of her conviction for stealing drugs while she held a job as a pharmacy technician, the release said.
The office had apparently failed to ask that worker whether she had ever been excluded from participating in federal health care programs or MaineCare at the time she was hired.
The office failed to check publicly available databases maintained by the U.S. Department of Health and Human Services’ Office of Inspector General and MaineCare’s Program Integrity Unit, despite federal regulations that bar employment of excluded providers, the release said.
Federal health care programs are prohibited from paying, directly and indirectly, for items or services furnished, ordered or prescribed by such excluded persons or entities. This prohibition extends to administrative and clerical workers and is not limited to health care providers, according to the release.
By failing to abide by the requirements of the MaineCare and federal health care programs involving the employment of excluded individuals, the Brunswick office acted with reckless disregard of the falsity of the claims it submitted to MaineCare and federal health care programs, the U.S. Attorney’s Office wrote.
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