An eye clinic in Texas will be required to face allegations that it engaged in Medicare fraud, billing more than $800,000 for fraudulent reimbursements.

A federal judge in Texas denied Outreach Diagnostic Clinic’s motion to dismiss the whistleblower lawsuit, stating that the government’s claims concerning the alleged health care fraud are specific enough to allow it to proceed.

The motion filed by Outreach Diagnostic Clinic said that the government lacked facts in its whistleblower lawsuit to support the allegations that the clinic violated the False Claims Act.

U.S. District Judge Lynn N. Hughes ruled that the alleged scheme Outreach doctors participated in by submitting false glaucoma test claims indicating potential Medicare fraud were detailed enough to allow the claim to continue.

“While this claim for fraud has a heightened pleading standard, it is not so high as to require the government to prove its case as it would at trial,” Judge Hughes stated. “The government describes a scheme, when it was done, who participated in it and how they tried to cover their tracks.”

Outreach is accused of submitting claims from February 2006 through December 2011. The claims exceed 14,450 claims for tests never performed, totaling in excess of $807,000. The company is accused of committing False Claims Act violations, common law fraud and unjustly enriching itself.

The Medicare fraud whistleblower lawsuit was originally filed in February 2012 when a former optometrist at Outreach, Michael S. stated he was told to submit fraudulent claims to Medicare for glaucoma tests he never performed.

The optometrist said his bosses asked him to perform actions considered health care fraud by billing for two tests to measure eye pressure: a tonometry test and tonography test.

In 2015 the government intervened, accusing the owner and ophthalmologist/medical director of committing Medicare fraud by billing Medicare for the tests when they did not even own the equipment required to perform the tests.

Outreach attempted to have the case dismissed in July, saying the plaintiffs had vague accusations and conclusory statements, according to the motion.

The government responded by indicating that sufficient factual information had been supplied in the Medicare fraud lawsuit, and Judge Hughes recently agreed with the government and allowed the lawsuit to proceed.

“Sorensen describes his observations of a scheme to submit false claims to the government, the time frame in which he observed it, each defendant’s role in the scheme and the code that was used to send the false claims to Medicare,” Judge Hughes stated. “He is not required to name a specific false claim and the date on which it was sent.”

The Medicare Fraud Whistleblower Lawsuit is Case No. 4:12-cv-00480, filed in the United States District Court for the Southern District of Texas.