Arcadia Doctor to Pay Medicare Fraud Damages

An Arcadia ophthalmologist has agreed to pay more than $375,000 to settle charges that he fraudulently billed the federal Medicare program for services that were never performed, federal prosecutors said Tuesday.

The settlement--roughly 10 times the actual losses alleged by the federal government--is one of the largest U.S. payments ever in a case involving an individual doctor, U.S. Atty. Nora M. Manella said.

The physician, Badurdin Kurwa, who operates Kurwa Eye Centers in Arcadia, Glendora and San Gabriel, also agreed to submit to a five-year, federally monitored compliance program. He will continue to be eligible to treat Medicare patients.

Under terms of the agreement, Kurwa admitted no wrongdoing.

The case was filed under the federal False Claims Act, the so-called whistle-blower law that allows individuals who bring fraud claims to share in the government’s settlement.

Sandra Hearn, a former administrator in Kurwa’s Arcadia office, filed a federal lawsuit against Kurwa in October 1996. The government later decided to join in it.

The suit alleges that Kurwa falsely billed Medicare for a diagnostic procedure known as endothelial microscopy that is sometimes performed on patients due to undergo cataract surgery. The government alleged that Kurwa submitted bills for roughly 900 patients, despite the fact that his offices lacked the sophisticated equipment used to perform the $100 test.

Hearn claimed that Kurwa falsified patient records in response to an audit request from a federal contractor that processes Medicare claims in Southern California, said Lisa Foster, an attorney for Hearn.

“Kurwa rewrote every one of the charts, then sent falsified reports to Medicare,” Foster said.

Whistle-blowers generally can receive 15% to 20% of the government’s settlement. Foster said Hearn and prosecutors have not yet reached agreement on Hearn’s share.

Kurwa’s attorney, Brian Hennigan of Los Angeles, said: “The difficult issue raised in this case related solely to alleged billing improprieties from [Kurwa’s] practice. There was no claim with regard” to the medical care received by Kurwa’s patients.