Acuity Eye Group Lawsuit

As you might have seen in the news headlines, yes, the Acuity Eye Group previously called the Retinal Institute of California Medical Group (RIC) was subjected to a very serious accusation of Medicare and Medicaid fraud, were you aware of that? Well, just so you know, this Acuity Eye Group Lawsuit process took place throughout California including Brawley, Calexico, and El Centro, yet the lawsuit did not reveal any misconduct in these particular offices. So, let’s just go over the details of it, and see what really was the case, shall we?

Who Was Accused?

Sure enough, the lawsuit filed by the plaintiffs caught the attention of several individuals and those who were involved, among them were doctors Tom Chang, Michael Samuel, and Michael Davis, CEO Brett Braun, and the San Gabriel Ambulatory Surgery Center. As per the details that are already out, you see, there was a Medicare and Medicaid fraud scheme that was charged against the individuals that were affected by this case which is a sort of health insurance program that took care of surgeries for several of the citizens, you know?

What Were They Accused Of?

Just to keep one simple thing in mind, the above-mentioned case was not about a few trivial matters, but rather an accusation of severe deception on the part of the group.

First of all, they were accused of patients’ co-payment waivers which are small amounts patients are supposed to pay for their treatment, did you know that already? Sure enough, from the outset, this might seem like something small, but here is the real thing, you see, mistakes were made, thus, they charged Medicare giving the patients’ co-payments as if they had paid them. Not just that though, the bills were artificially inflated making them look far more than they were. This is against the law unless the patient is one who qualifies for financial hardship exemptions.

Second, they were accused of the unnecessary charging of treatments, and how’s that? Well, in some cases, procedures that weren’t even performed were claimed. The rest of the claims didn’t sufficiently supply the medical records in order to back them up, something that is not permissible in the Medicare system, you know?

Not just that though, lastly, the filing of the suit indicated that such things had not happened just once. There are allegations that they kept on doing this over and over again to profit even more off patients.

So, What Happened Next? The Settlement!

It is a 100% true that the case was settled instead of being taken to court by Acuity Eye Group and the other parties involved. As per the timeline, well, on October 1, 2019, both parties announced that they would jointly pay a settlement fee, and the total amount reached 6.65 million US dollars, and that’s pretty fair if you think about that. Just so you know though, of that, they paid over six million of the total amount to the government of the United States, while the government of California received approximately $296,000. Crucially, settling does not amount to admitting being guilty, they simply agreed to pay and conclude the case.

Did It Affect All Their Offices?

You see, there is kinda good news for residents of Imperial County, the area where Acuity Eye Group operates its branches: Brawley, Calexico, and El Centro are the areas where there are no signs of fraudulent behavior. So yes, in a way, the fraudsters have not touched your little offices in that area. They were primarily targeting the operations in such counties as Los Angeles, Orange, and Riverside, which are particularly different from the little towns of your own, you know? So for sure, if you have visited any of those small offices, you should not assume that any fraudulent actions took place there.