Colorado to receive over $1 million in Medicaid fraud settlement with optical lens company
Sept. 8, 2022 – Attorney General Phil Weiser today announced that Colorado will receive more than $1 million after an optical lens company paid providers kickbacks to refer patients to the company, resulting in the submission of false claims to the Colorado Medicaid program.
In the settlement, Essilor, a company that manufactures, markets, and distributes optical lenses and equipment used to produce optical lenses, agreed to pay 35 states a total of $22 million plus interest.
“Kickbacks like those Essilor offered can harm consumers by leaving them with products that are not in their best interest. In this case, the kickbacks affected some of the most vulnerable Coloradans,” Weiser said. “Our office will continue to hold accountable companies that use such underhanded tactics to defraud the state’s Medicaid program.”
The settlement resolves allegations that between Jan. 1, 2011, and Dec. 31, 2016, Essilor knowingly and willfully offered to pay or paid eye care providers, such as optometrists and ophthalmologists, to purchase Essilor products for their patients, including Medicaid beneficiaries. Essilor’s conduct violated the Federal and Colorado’s False Claims Statute and resulted in the submission of false claims to the Colorado Medicaid program.
As part of the settlement, Colorado will receive $1,096,985.36 in restitution and other recoveries.
This settlement arises from two whistleblower lawsuits filed in the United States District Court for the Northern District of Texas and the Eastern District of Pennsylvania. A team from the National Association of Medicaid Fraud Control Units participated in the settlement negotiations on behalf of the states. The team included representatives from the offices of the Attorneys General for the states of California, Colorado, Indiana, Pennsylvania, and Texas.
The Attorney General’s Medicaid Fraud Control Unit is dedicated to protecting the integrity of the system that provides healthcare to the most vulnerable Coloradans. It accomplishes this through the investigation and prosecution of Medicaid provider fraud as well as the investigation and prosecution of the abuse and neglect of Medicaid clients in non-institutional settings as well as the abuse and neglect of patients in institutions that receive Medicaid dollars. To report potential Medicaid fraud, click here or call (720) 508-6696.