AUSTIN, Texas - Dr. Tony Jacob, an optometrist who operated a network of optometry practices in Central Texas, has agreed to pay the United States and the State of Texas $1,055,379.96 to resolve allegations under the Federal False Claims Act and the Texas Health Care Program Fraud Prevention Act. Under the terms of the settlement, the United States will receive $922,071.59 and the State of Texas will receive $133,308.37.

The United States alleged that Dr. Jacob's optometry practices submitted claims to TRICARE, Medicare, and Medicaid using the National Provider Identifiers (NPIs) of optometrists who did not perform the services billed. An NPI is a unique identification number used by healthcare providers in administrative and financial transactions, including enrolling in Federal healthcare programs and submitting claims for reimbursement. Dr. Jacob's optometry practices allegedly submitted claims under the wrong NPI in circumstances where the optometrist who rendered services was not credentialed or enrolled in the Federal healthcare program billed.

"Providers who submit inaccurate billing information threaten the integrity of program funds," said U.S. Attorney Jaime Esparza of the Western District of Texas. "We will continue to work with our law enforcement partners to ensure that providers do not circumvent rules meant to ensure patients appropriate, quality services from physicians who are actually approved to participate in Federal healthcare programs."

"The Defense Criminal Investigative Service (DCIS), the law enforcement arm of the DoD Office of Inspector General, is steadfastly committed to protecting the integrity of the TRICARE Program, which is vital to the health and well-being of our warfighters, retirees, and their families," said Acting Special Agent in Charge Ryan Settle of DCIS's Southwest Field Office. "DCIS and our prosecutorial partners will tirelessly pursue and prosecute individuals who seek to enrich themselves by jeopardizing the healthcare of TRICARE beneficiaries and defrauding American taxpayers."

The civil settlement resolved a lawsuit filed under the qui tam or whistleblower provision of the False Claims Act, which permits private parties to file suit on behalf of the United States for false claims and share in a portion of the government's recovery. The qui tam lawsuit is captioned United States and Texas ex rel. Shealy v. Jacob, et al., No. 1:21-CV-1111(W.D. Tex.).

Assistant U.S. Attorney Thomas Parnham negotiated the settlement on behalf of the United States.

The claims resolved by the settlement are allegations only and there has been no determination of liability.

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