CHARLESTON, WV (WOWK) – A settlement has been reached in a lawsuit against an ophthalmologist accused of submitting false claims to Medicare and Medicaid.
According to United States Attorney Will Thompson and the U.S. Department of Health and Human Services’ Office of the Inspector General, Dr. Craig M. Morgan and Eye Consultants of Huntington, Inc, agreed to pay $907,074.64 in the lawsuit.
The lawsuit claims Morgan is accused of “routinely” administering “vascular endothelial growth factor inhibitor” injections into patients’ eyes to treat alleged wet age-related macular degeneration (Wet-AMD) and other conditions injections are used to treat.
According to Thompson and the DHHS, those injections were not medically necessary and the patients allegedly did not have the conditions for those treatments. The lawsuit states this went on between Jan. 13, 2013 and April 12, 2019.
“This settlement is important because it shows that this office, along with its federal partners, will aggressively seek re-imbursement when taxpayer money is spent wrongly,” Thompson said. “When a person goes to a medical provider, they expect the medical provider to treat them, not for the medical provider to figure out ways to enrich themselves.”
According to the DHHS-OIG, Morgan was identified as a “top outlier” across all medical specialists in the Mountain State for billing Medicare. The lawsuit alleges Morgan far exceeded the average number of Medicare claims his peers were submitted, the majority of which were for injections to treat Wet-AMD.
“Providers who perform medically unnecessary procedures damage the trust of physician-patient relationships and exploit taxpayer-funded programs,” said HHS-OIG Special Agent in Charge Maureen Dixon. “HHS-OIG, and our law enforcement partners, are committed to working together to protect the integrity of federal health care programs.”