Fla. Optometrist Sees What Can Happen When Medicaid Claims are Falsified

Florida Attorney General Charlie Crist this week announced the arrest of a Hollywood optometrist on charges that he falsified claims to the Florida Medicaid program.

Lorry Rubensteen, 48, of Hollywood, was charged with one count of grand theft, a third-degree felony punishable by up to five years in prison and a $5,000 fine. Investigators determined that Rubensteen billed an additional service date for each legitimate claim, indicating that as many as half his Medicaid billings could be fraudulent. Records reportedly show that from January 2002 to the present, Rubensteen billed the Medicaid program for more than $490,000.

The arrest follows an investigation into the billing practices of Rubensteen, a licensed optometrist and owner of EMA Eyewear Inc., in Pembroke Pines. The investigation, by the Attorney General’s Medicaid Fraud Control Unit, showed that Rubensteen was billing an average of more than $1,000 per patient, with all his patients reported as having the same or similar diagnoses. A review of Medicaid billing records reportedly revealed that Rubensteen was double-billing the State of Florida Medicaid Program for duplicate eyeglasses he was not providing to his patients.

The state Agency for Health Care Administration (AHCA) also conducted a preliminary audit of Rubensteen’s Medicaid claims, uncovering overpayments totaling approximately $12,500 in Medicaid claims that were actually paid. AHCA found a consistent pattern of Rubensteen re-billing for the same services on subsequent dates, a consistent pattern of billing for a particular diagnostic procedure known as extended ophthalmoscopy, and the concurrent billing of metal and plastic eyeglass frames.

Medicaid fraud investigators with the Attorney General’s Office visited Rubensteen’s eye clinic posing as Medicaid recipients. Subsequent Medicaid billings for the undercover investigators revealed that Rubensteen submitted duplicate eyeglass claims.

The case will be prosecuted by the Broward County State Attorney’s Office.