E. Bruce DiDonato, an optometrist who founded Campus Eye LLC and Campus Eye Surgery Center LLC in Hamilton Township, has been charged in a seven-count indictment related to health care fraud and illegal kickbacks, according to the U.S. Attorney’s Office for New Jersey.
DiDonato, who lives in Lawrence Township, was charged on July 29 with one count each of conspiracy to commit health care fraud and conspiracy to offer and pay health care kickbacks in connection with illegal referrals; two substantive counts of health care fraud; and three substantive counts of paying health care kickbacks.
In 2021, DiDonato sold a portion of his interest in Campus Eye LLC and Campus Eye Surgery Center LLC to a private equity firm, according to documents filed in the case and statements made in court.
DiDonato, 71, became the CEO of the newly formed Campus Eye Management Holdings LLC and its wholly owned subsidiary, Campus Eye Management LLC.
The two entities of which he was CEO – Campus Eye Management Holdings LLC and Campus Eye Management LLC – operated the optometry care practice and outpatient eye surgery center in Hamilton Township.
Before and after he and outside investors formed the Campus Eye entities and he became the CEO, DiDonato and others engaged in Medicare fraud by performing and billing for unnecessary diagnostic tests at the eye surgery center. The actions occurred from at least 2015 through March 2023, according to court documents.
DiDonato allegedly paid kickbacks and bribes to ophthalmologists in exchange for referring patients who needed eye surgeries to the eye surgery center.
Diagnostic tests were ordered that duplicated tests the patients had already received. Also, some of the tests were not needed for the type of surgery to be performed.
Neither DiDonato nor the optometrist reviewed the tests. In most instances, the ophthalmologists did not review the tests or rely on them to determine treatment decisions ahead of surgery.
Optometrists and ophthalmologists both focus on eye care, but optometrists go to optometrist school and ophthalmologists go to medical school. Ophthalmologists can perform eye surgery, but optometrists cannot.
To hide the kickbacks and bribes, DiDonato allegedly created sham agreements that describe the payments as consulting fees that were paid as a monthly flat fee.
The flat fees were based on a percentage of the optometry practice’s Medicare reimbursement for the tests performed on patients who had been referred to the practice in the previous year.
Approximately $3.4 million in fraudulent claims were submitted to Medicare, of which it paid about $1 million.
If DiDonato is convicted, he faces a maximum sentence of 10 years in prison on the health care fraud conspiracy and substantive health care fraud counts. He also faces five years for the kickback conspiracy count and 10 years for each of the substantive healthcare kickbacks.
Meanwhile, the U.S. Department of Justice will not prosecute the Campus Eye entities for the healthcare fraud and kickback scheme because of its timely and voluntary self-disclosure of the misconduct, plus its full cooperation with the investigation and remediation steps, officials said. The Campus Eye entities have agreed to pay back $1 million.
