PIERRE, S.D. (Legal Newsline) - South Dakota Attorney General Marty Jackley, U.S. Attorney Brendan Johnson and the U.S. Department of Health and Human Services special agent Gerald Roy announced a settlement Tuesday with a Rapid City optometrist.
M. Scott Ellender allegedly engaged in the knowing submission of false claims to Medicare, Medicaid and TRICARE. Between June 1, 2006, and Dec. 31, 2012, Ellender allegedly submitted improper claims to Medicaid for new patient visits, trifocal lenses and bifocal lenses. Ellender also allegedly submitted claims for medically unnecessary visual field examinations.
Under the terms of the settlement, Ellender will pay $283,499 to resolve the allegations. Ellender denied the allegations and did not admit liability as part of the agreement to avoid protracted litigation.
Ellender and his practice, Budget Optical, also will enter an integrity agreement with the HHS Office of Inspector General.
As part of a separate agreement with South Dakota, Ellender spoke to a group of providers about the matter and will provide free eye care to underserved patients for one year.
The case was a joint effort handled by Jackley's Medicaid Fraud Control Unit, the HHS-OIG, TRICARE, the Office of U.S. Attorney for South Dakota and the South Dakota Department of Social Services.