Augusta Optometrist Pleads Guilty to Health Care Fraud Charge

AUGUSTA, GA—Jeffrey Sponseller, 47, of Augusta, Georgia, pleaded guilty today before United States District Court Judge J. Randal Hall to submitting over $800,000 in fraudulent claims to Medicare.

Evidence presented at today’s guilty plea hearing showed that Sponseller, an optometrist and an owner of Eye Care One, located at 3152 Washington Road in Augusta, Georgia, submitted claims to Medicare for payment for eye examinations of nursing home patients. Instead of billing Medicare for the actual service he was providing at the nursing homes, Sponseller claimed that he was conducting the most expensive type of eye examination, which typically lasts 45 minutes. An example of this health care fraud presented at today’s guilty plea hearing involved a July 27, 2009 visit by Sponseller to a nursing home in Americus, Georgia, where Sponseller billed Medicare for 177 patients that he claimed to have examined individually for 45 minutes each during that one-day visit. As a result of this type of fraudulent billing, Medicare paid Sponseller for that type of eye exam more than any other doctor in the United States in 2009.

United States Attorney Edward J. Tarver said, “Health care fraud is a cancer on the financial health of our nation. In many cases, such as with this defendant, it is committed by professionals who are well educated and highly regarded. Whether that fraud is perpetrated by an optometrist willing to claim that he worked the equivalent of five-and-a-half days during a one-day visit to a nursing home—like this defendant did—or a medical equipment supplier that bills Medicare without authorization, the ultimate injury is to the American taxpayer. The United States Attorney’s Office and its law enforcement partners will actively pursue those who abuse our country’s health care programs for financial gain.”

Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General for the Atlanta region, said, “Any time false claims are submitted for payment, our nation’s health insurance programs and beneficiaries suffer. Protecting precious Medicare funds remains a top priority for the Inspector General and our law enforcement partners.”

Sponseller faces a maximum penalty of five years’ imprisonment and a fine of up to $250,000, in addition to paying restitution. The date for Sponseller’s sentencing hearing has not yet been scheduled.

FBI Special Agents Paul Kubala and Jason Gustin, U.S. Attorney’s Office Investigator Kimberly Reinken, HHS-OIG Special Agent David Graupner, and IRS Special Agents Roger Garland and Jeffrey Hale participated in the investigation of this case. Assistant United States Attorney David Stewart is prosecuting in this case. For additional information, please contact First Assistant United States Attorney James D. Durham at (912) 201-2547.