On April 16, 2015, Attorney General Sam Olens announced that Georgia has reached an agreement with Doraville doctor Zheng Xiang Wang and the Wang Eye Clinic, P.C., to settle allegations that Dr. Wang billed Georgia Medicaid for medically unnecessary ophthalmology procedures. In settlement of the allegations, Dr. Wang paid $790,000 to the Department of Community Health (DCH), which administers Georgia’s Medicaid program.
As a condition of receiving payment for services rendered, DCH requires medical providers to certify that procedures are accurate as described and also medically necessary. The False Medicaid Claims Act, O.C.G.A. § 49-4-168 et seq, makes it illegal to knowingly submit false or fraudulent claims to the State of Georgia for payment. For each false claim, the Act allows the state to recover triple damages and a penalty from $5,500 to $11,000.
The agreement settles allegations that Dr. Wang submitted claims for payment of certain eye procedures which were not medically necessary: (1) insertion of tear duct plugs; (2) punctures of the cornea; and (3) photography of the inside of the eye. In addition, the agreement settles allegations that, in billing for office visits, Dr. Wang overstated the level of service actually rendered.
“Performing unnecessary medical procedures is irresponsible and shortsighted,” said Olens. “Unnecessary procedures permanently impact a patient’s medical record, damage the trust the public has in its doctors, and increase the costs of healthcare for everyone.”
In connection with the settlement, Dr. Wang also entered into a voluntary exclusion agreement with the United States Department of Health and Human Services Office of the Inspector General (“HHSOIG”). This agreement bans Dr. Wang from all government healthcare programs, including Medicaid and Medicare, for at least five years.
The case was investigated by the Georgia Medicaid Fraud Control Unit, a division of the Attorney General’s office. Assistant Attorneys General Kevin Bradberry and Steven Lee handled the case on behalf of the State of Georgia. The investigation was conducted by Investigator Chekesha Johnson, Nurse-Investigator Nancy Goddard, Auditor Anita Reddick, Auditor Bernadette Calhoun, and Intelligence Analyst Vanda Russell with the assistance of the Georgia Department of Community Health, the Federal Bureau of Investigation, and the U.S. Department of Health and Human Services.