CT Eye Care practice fined over $190K

Dept of Justice, U.S. Attorney’s Office, District of CT

Friday, March 18, 2022 

Windham Eye Care Practice and its Owners Pay $192K for Employing “Excluded” Individual
Leonard C Boyle, United States Attorney for the District of Connecticut, today announced that WINDHAM EYE GROUP, P.C., an ophthalmological medical practice located in Windham, and its owners, DANA WOODS, M.D. and WILLIAM KAUFOLD, M.D., have entered into a civil settlement agreement with the federal and state governments to resolve allegations that they improperly employed an individual who was excluded from all federal healthcare programs.

To resolve their liability, Windham Eye Group, Woods and Kaufold will pay $192,699.

Windham Eye Group employed Michael Vallone as its practice administrator between February 2010 and May 2021. Vallone had previously been convicted in the District of Jersey of health care fraud. As a result of his conviction, he was excluded from all federal health care programs.

When the U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG) excludes an individual or entity from federal health care programs, no program payments may be made for items or services furnished by that excluded individual or entity. In September 1999, HHS-OIG issued a Special Advisory Bulletin in order to provide guidance to health care providers who might employ or contract with an excluded individual or entity. In May 2013, HHS-OIG issued an Updated Special Advisor Bulletin containing additional guidance. Both the original and updated Special Advisory Bulletins advised that, in order to avoid potential liability, health care providers should check the List of Excluded Individuals/Entities on the HHS-OIG web site (http://oig.hhs.gov/exclusions).

During the time that Vallone served as the practice administrator for Windham Eye Group, the practice and its owners billed and sought reimbursements from federal healthcare programs, including Medicare, Medicaid, and TRICARE. A portion of the reimbursements that Windham Eye Group and its owners received were used to pay Vallone’s salary and benefits.

This matter was investigated by the Office of Inspector General for the Department of Health and Human Services. The case is being prosecuted by Assistant U.S. Attorney Richard M. Molot and Assistant Attorney General Greggory O’Connell of the Connecticut Office of the Attorney General.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.