Somerset optometrist claimed to examine patient 61 times in four years, lawsuit alleges

bestep@herald-leader.comMay 14, 2013 

A Somerset optometrist and the practice where he works submitted hundreds of fraudulent claims for payments from Medicaid and Medicare, U.S. Attorney Kerry B. Harvey's office has alleged in a lawsuit.

Many of the examinations Dr. Philip Robinson claimed to have performed were unnecessary, the lawsuit claims. Robinson works at Associates in Eye Care P.S.C., and provided eye-health services to nursing home residents.

On 271 occasions between January 2007 and January 2012, Robinson said he examined 50 or more patients in a day, the lawsuit said. On 11 of those days, Robinson claimed he saw more than 100 patients, according to the complaint, which was filed Monday.

The lawsuit said it would have been impossible to correctly perform that many exams. To perform the number of services Robinson claimed on March 22, 2007, under accepted guidelines, he would have needed to be at the nursing home more than 20 hours, the complaint said.

In the last six months of 2008, Robinson submitted more claims to Medicaid and Medicare than any other optometrist in the nation, the complaint said.

Robinson went to the nursing homes every four to six weeks and claimed to examine all or most of the residents, which was not necessary, Harvey's office said in the lawsuit. He submitted claims for examining one resident of a Somerset nursing home 61 times in four years, the lawsuit said.

In 2011 alone, Medicare reimbursements for the work Robinson said he performed totaled more than $400,000, the lawsuit said.

The complaint seeks an unspecified amount of money in the form of reimbursement to the government and fines of between $5,500 and $11,000 for each false claim.

An attorney for Associates in Eye Care, Jennifer L. Wintergerst, said the company and Robinson "vehemently dispute" the allegations in the lawsuit.

Robinson is the only optometrist seeing patients in several nursing homes in 10 counties, and many of them need to be closely monitored because of age and health conditions, so his high caseload is to be expected, Wintergerst said.

"His focus has always been to treat these patients as he would hope his loved ones would be treated," Wintergerst said.

Associates in Eye Care has offices in Somerset, Whitley City, Williamsburg and Albany, according to its website.

Bill Estep: (606) 678-4655. Twitter: @billestep1

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