Lensmaker Essilor to Pay $16.4M to Resolve Kickback Claims

WASHINGTON — Lensmaker Essilor has agreed to pay $16.4 million to resolve allegations it caused claims to be submitted to Medicare and Medicaid that violated federal anti-kickback statutes. 

Essilor, headquartered in Dallas, Texas, manufactures, markets and distributes optical lenses and equipment used to produce optical lenses. 

The Justice Department alleged that between Jan. 1, 2011, and Dec. 31, 2016, the company knowingly and willfully offered or paid remuneration to eye care providers, such as optometrists and ophthalmologists, to induce those providers to order and purchase Essilor products for their patients, including Medicare and Medicaid beneficiaries, in violation of the Anti-Kickback Statute. 

The Anti‑Kickback Statute prohibits offering or paying anything of value to induce the referral of items or services covered by Medicare, Medicaid and other federally funded programs. The statute is intended to ensure that medical providers’ judgments are not compromised by improper financial incentives.

“When medical equipment manufacturers provide kickbacks to referring providers, it can compromise the integrity of medical decision-making,” said Principal Deputy Assistant Attorney General Brian Boynton, head of the Justice Department’s Civil Division.

“The department will continue to pursue violations of the Anti-Kickback Statute to ensure that patient care is not influenced by improper financial incentives,” Boynton said.

U.S. Attorney Chad Meacham of the Northern District of Texas, added, “We are pleased to see Essilor taking financial responsibility for their conduct.”

In connection with the settlement, Essilor entered into a five-year Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General. 

The agreement requires, among other things, that Essilor hire an independent review organization to review its systems, policies, processes and procedures for ensuring that any discounts, rebates or other reductions in price offered to providers comply with the Anti-Kickback Statute. 

The agreement also requires Essilor to implement a new written review and approval process to ensure all existing and new discount arrangements comply with the Anti-Kickback Statute.

Dan can be reached at [email protected] and @DanMcCue