Fraud Week: Optical Lens Maker Reaches Kickback Settlement

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On August 23, the U.S. Department of Justice announced that Dallas-based optical lens manufacturer Essilor International and its affiliates agreed to pay $16.4 million to settle alleged violations of the federal Anti-Kickback Statute (AKS). Three former Essilor district sales managers filed a whistleblower suit under the False Claims Act claiming that between 2011 and 2016, the company paid remuneration to eye care providers, including optometrists and ophthalmologists, to induce them to order and purchase Essilor products for their patients.

The AKS prohibits offering or paying anything of value to induce the referral of items or services covered by Medicare, Medicaid and other federal healthcare programs. If the AKS has been violated, the claims submitted to federal programs for such items or services are considered “false claims.”

As part of the settlement, Essilor entered into a five-year Corporate Integrity Agreement (CIA) with the U.S. Department of Health and Human Services’ Office of Inspector General. The CIA requires, among other things, that Essilor review all of its discounts, rebates, and other price reductions offered to providers to ensure compliance with the AKS.

Essilor also settled related Medicaid claims for an additional $5.5 million, to be divided among 35 states.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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