The U.S. Department of Justice announced on January 15, 2026 that Florida ophthalmology practices Clay Eye Holdings LLC, Retina Macula Specialist of Miami LLC, Florida Eye Institute P.A., Miami Eye LLC, and Kendall Eye Institute Inc. have agreed to pay a total of nearly $6 million to resolve alleged violations of the False Claims Act arising from their billing for trans-cranial doppler ultrasounds (TCDs) through a kickback arrangement with a third-party testing company. All five practices have agreed to cooperate with the Justice Department’s ongoing investigations of other participants in the alleged scheme.
The settlements resolve allegations that the settling practices knowingly submitted, and caused the submission of, false claims to Medicare and Medicaid for medically unnecessary TCDs. The settling practices performed TCDs on thousands of patients and billed Medicare and Medicaid hundreds of dollars per test. Before the patients received the results of the test, the practices and the third-party testing company identified the patients as having received a serious diagnosis that could qualify the patient for reimbursement of a TCD by Medicare or Medicaid. However, nearly all patients who received TCDs never had that diagnosis, and it was not reflected in the patient’s medical history or in the TCD results. The settling practices paid the third-party testing company based on the volume or value of tests ordered and referred the patients to the testing company’s preferred radiology group for the TCDs’ professional component.
The United States alleged that as a result of this scheme, the settling practices submitted, or caused the submission of, false claims to Medicare and Medicaid for TCDs between January 1, 2018 and June 1, 2022 that were medically unnecessary, that were premised on false diagnoses, and that resulted from violations of the Anti-Kickback Statute and the Stark Law.
As a result of the settlements, Clay Eye Holdings LLC will pay $2,140,000, Retina Macula Specialist of Miami LLC will pay $1,750,000, Florida Eye Institute P.A. will pay $1,250,000, Miami Eye LLC will pay $525,000, and Kendall Eye Institute Inc. will pay $310,000. Of the total settlement amount, $333,500 will be paid to the State of Florida for its share of Medicaid, which is a jointly funded federal and state program.
The civil settlements resolved claims in a lawsuit filed under the qui tam or whistleblower provision of the False Claims Act, which permits private parties to file suit on behalf of the United States for false claims and share in a portion of the Government’s recovery. The qui tam was filed by a whistleblower who will receive $1,135,250 in connection with the settlements.
If you have information regarding false claims having been submitted to Medicare or Medicaid and the information is not publicly known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
Visit our website or call us toll-free in the United States at 800-295-3959 to be connected with qui tam lawyers (False Claims Act lawyers) in your U.S. state who may assist you with a False Claims Act lawsuit.
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