• DOJ Declines To Prosecute Optometry Company Under New Corporate Enforcement Policy After Self-Disclosure

  08/04/2026

  On July 29, 2026, the National Fraud Enforcement Division of the Department of Justice (“DOJ”) declined to prosecute a management services organization and its holding company (collectively, “Optometry Company”) that provided billing and other administrative services to an optometry practice and an affiliated ambulatory surgery center (collectively, “Practice”) for health care fraud, illegal kickbacks and bribes, and conspiracy, pursuant to Part I of the DOJ’s Corporate Enforcement and Voluntary Self-Disclosure Policy (“CEP”).  The Practice was founded and controlled by an individual (“Founder”) who later formed Optometry Company with outside investors.  Acting Attorney General Blanche announced the new CEP on March 10, 2026.  The decision resolves a criminal health care fraud investigation and requires Optometry Company to pay $1 million in disgorgement to victims.  The DOJ separately announced a seven-count indictment against the Founder for allegedly orchestrating diagnostic testing and kickback schemes.

  The DOJ alleges that, beginning in approximately 2015, the Founder personally directed a scheme to pay kickbacks to ophthalmologists for patient referrals—concealed as sham consulting fees—and to bill Medicare and other insurers for duplicative or medically unnecessary diagnostic eye tests performed on the referred patients.  In July 2021, the Founder and outside investors formed Optometry Company, in advance of the investors’ purchase of equity, which closed in December 2021.  From December 2021 through March 2023, the Founder—now serving as Optometry Company’s CEO—caused Optometry Company to submit claims to Medicare on the Practice’s behalf and caused the Practice to continue paying kickbacks, thereby furthering the scheme through the newly formed entities.  The conduct constituted health care fraud (18 U.S.C. § 1347), the offer and payment of illegal health care kickbacks and bribes (42 U.S.C. § 1320a-7b), and conspiracy (18 U.S.C. §§ 371, 1349).  In total, the Founder allegedly caused the submission of approximately $3.4 million in fraudulent claims to Medicare, of which Medicare paid approximately $1 million.

  The DOJ credited Optometry Company with timely and voluntary self-disclosure of the misconduct, full cooperation with the investigation (including an agreement to continue cooperating with any related proceedings), and prompt remediation, including revisions to its billing, payment, and compliance policies.  The DOJ also cited the absence of aggravating factors and Optometry Company’s agreement to compensate victims as supporting a declination to prosecute.  Notably, the letter agreement makes clear that it provides no protection against prosecution of any individuals affiliated with Optometry Company, regardless of position.

  This resolution marks the DOJ’s first declination to prosecute a health care company under the CEP.  The resolution confirms that the DOJ will honor the CEP’s incentives even where the underlying misconduct predates the CEP’s announcement and the dollar amounts at issue are significant, while continuing to pursue the individuals responsible.

  Categories: Bribery,  Compliance,  Criminal Enforcement,  Disgorgement,  DOJ,  Financial Fraud,  Investigations
  

Links & Downloads

• DOJ ARTICLE ON DECLINATION OF OPTOMETRY COMPANY UNDER CEP
  
• CAMPUS EYE DECLINATION LTR SIGNED