Dr. Tony Jacob, a Texas-based optometrist, has agreed to pay $1 million to resolve allegations of violating the False Claims Act. The settlement, announced on November 1 by the U.S. Attorney’s Office for the Western District of Texas, addresses claims that Dr. Jacob submitted fraudulent claims to federal healthcare programs.
The fraudulent activities allegedly involved submitting claims to TRICARE, Medicare, and Medicaid using National Provider Identifiers (NPIs) of optometrists who did not perform the billed services and billing for services rendered by optometrists who were not credentialed or enrolled in the federal healthcare program being billed.
U.S. Attorney Jaime Esparza of the Western District of Texas emphasized the severity of such actions, stating that inaccurate billing information threatens the integrity of program funds. The Defense Criminal Investigative Service (DCIS) played a crucial role in this case. Acting Special Agent in Charge Ryan Settle of DCIS’s Southwest Field Office reaffirmed their commitment to protecting the TRICARE Program, which is vital for the healthcare of military personnel, retirees, and their families.
This settlement resulted from a qui tam whistleblower suit filed against Dr. Jacob. Under the False Claims Act individuals can file lawsuits alleging government contracting fraud on behalf of the United States. Whistleblowers are eligible to receive between 15% and 30% of the settlement in successful cases but the whistleblower’s share in this particular case has not yet been determined.
This case serves as a reminder of the ongoing efforts to strengthen laws that support and protect whistleblowers who report allegedly fraudulent activities in the healthcare sector.
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