Doctors Behaving Beautifully: Memphis optometrists earn a black eye for reporting Medicare fraud

The physicians in the Eye Specialty Group in Memphis thought that their partner, Dr. Seth Yoser, was faking out patients.

They investigated and turned their findings over to the Centers for Medicaid and Medicare Services. They alleged that instead of giving patients full doses of a drug used to treat macular degeneration and prevent blindness, Yoser was giving them half a dose or no dose at all.

That would have been bad enough.

But Yoser allegedly took the fakery a step further. He sold the unused vials of Lucentis, worth about $2,000 each, to a medical supplier who then sold them back to Eye Specialty Group.  

Thanks to the group's tip, federal prosecutors were able to build a strong case against Yoser. They accused him of falsely billing the agency for $1.6 million in drugs that he never actually used to treat patients. In July, Yoser pleaded guilty to 35 federal fraud charges as part of a plea agreement. He is scheduled to be sentenced on Thursday.

As a reward, the medical group is stuck with the bill. As Tom Wilemon of the Memphis Daily News explained in a great piece about the case:

The practice now has to pay back hundreds of thousands of dollars to the federal government, write off about $300,000 worth of expired drugs and cover the costs of an internal investigation plus a civil lawsuit against Dr. Seth Yoser, the partner they reported to authorities.

The Tennessee Board of Medical Examiners has yet to lift a finger. The board's spokesman, Shelley Walker, gave this surprisingly blunt response to the Memphis Daily News:

"There is no state law, nor is there any rule within the boards, for health professionals that automatically prompts action against a licensed health professional for a criminal conviction," Walker said. "In other words, a criminal conviction or even an arrest does not prompt automatic action against the health professional's license."

Message to patients: Don't expect the medical board in Tennessee to protect you from doctors who perform fake treatments on very real diseases.

If you are a patient at the Eye Specialty Group, though, you can rest assured that the doctors are looking out for you – no pun intended.

Final question: How does Medicare expect doctors to report fraud if they are going to be forced to pay back penalties to the government? Should the burden be on the perpetrator? And should any deal prosecutors cut with the accused require that doctor to pay back the government, the medical group and any other victims?