Judge orders 2 ophthalmologists to pay $170M for false claims violations

Alia Paavola -

Two ophthalmologists and their eye clinic were ordered to pay more than $170.5 million for fraudulently billing Medicare for the evaluation and treatment of glaucoma, the Justice Department said Nov. 18. 

U.S. District Judge Lynn Hughes assessed the penalties against Mustapha Kibirige, MD and Emelike Agomo, MD, and their Houston eye clinic Outreach Diagnostic Clinic.

According to the Justice Department, the two ophthalmologists allegedly fraudulently billed Medicare for single eye pressure measurement tests used to assess and treat glaucoma and used an improper reimbursement code that provided higher reimbursements. 

The judge determined that the practice submitted 14,450 false claims to Medicare between 2006 and 2012. The judge assessed a penalty of $11,803 for each of the false claims, resulting in a total of more than $170.5 million.

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