Paul S. Koch Paid Kickbacks for Medicare Patients, Providence RI, 2024

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Defendant Pays $1.1M for Medicare Kickbacks

PROVIDENCE – Former Rhode Island ophthalmologist Paul S. Koch, M.D., has agreed to pay $1,166,072 to settle civil allegations that he paid kickbacks to optometrists who referred patients to him for cataract surgeries, announced United States Attorney Zachary A. Cunha.

The agreement resolves claims brought as part of a qui tam complaint filed in federal court in the District of Rhode Island by two whistleblowers.

“Patients should be able to feel secure that when their doctors make decisions that impact their health, whether about prescriptions, surgeries, or referrals, those decisions are based on sound medical judgment, and not illegal monetary incentives,” said U.S. Attorney Cunha.

According to the government, Koch paid kickbacks to optometrists for referring patients to him for cataract surgeries between January 1, 2013, and December 31, 2017. The government alleges that these payments to the referring optometrists were illegal under the anti-kickback statute, a federal law that prohibits financial payments to induce medical referrals that are reimbursed by federal healthcare payors, like the Medicare program.

The government’s case was litigated by Assistant United States Attorneys Dulce Donovan and Bethany N. Wong and was investigated by the U.S. Department of Health and Human Services, Office of Inspector General and the FBI Boston Division.

The whistleblowers will receive $256,534.84 out of the settlement payment.

The settlement makes it clear that medical decisions by doctors should be based on what is best for each patient, not a doctor’s personal financial interest.