PIERRE, SD- Attorney General Marty Jackley announced today that South Dakota has reached a civil settlement agreement with Advanced EyeCare, P.C., of Sioux Falls, SD, in a case involving Medicaid payments.
"We are working to protect taxpayer dollars by ensuring that providers submit claims for goods and services that are medically necessary," Jackley said. "It is important to guard taxpayer monies by paying only legitimate claims."
Advanced EyeCare will pay $151,528.89 as part of the settlement agreement. The settlement funds will be used to reimburse federal and state shares of Medicaid expenditures, and for costs of investigation. Jeffrey J. Browen, OD, signed the settlement agreement as president of Advanced EyeCare. Dr. Browen also agreed to participate in additional training. Dr. Browen terminated his South Dakota Medicaid provider status in October 2015.
According to the settlement agreement, South Dakota contends that Advanced EyeCare submitted at least some claims for payment for services that were not medically necessary or were improperly coded. The settlement agreement is neither an admission of liability by Advanced EyeCare, nor a concession by South Dakota that its claims are not well founded.
Information provided by patients and other physicians assisted the government’s review of the case.
"We appreciate the assistance provided by patients and physicians to our team,” Jackley said. “We also appreciate the assistance and resources provided by our local, State, and Federal partners.”
The case was handled by the South Dakota Medicaid Fraud Control Unit, with assistance from the South Dakota Department of Social Services, the South Dakota Division of Criminal Investigation, the US Department of Health and Human Services - Office of Inspector General, the US Department of Health and Human Services - Centers for Medicare & Medicaid Services, the US Defense Health Agency Inspector General, the Sioux Falls Police Department, and Health Integrity.