Now 4 2009 NOW-G4-2889 18:81 FL DEPT OF HEALTH 856 488 1855 P.@S STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, ve | . CASE NO. 2008-23824 GLENN D. PIESCHKE, 0.D., Respondent. ADMI RATIVE COMPLAIN COMES Now, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Optometry against Respondent, Glenn D. Pieschke, O.D., and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of optometry pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 463, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed optometrist (0.D.) within the state of Florida, having been issued license number OP 2383. 3, Respondent's address of record is 3927 SE 38th Loop, Ocala, Florida 34480. Now 4 2009 10:30 NOW-G4-2889 18:81 FL DEPT OF HEALTH 856 488 1855 P.@6 4. On or about March 22, 2007, CD presented to Dr. Pieschke at Lange Eye Care, located at 11834 CR 101, Oxford, Florida, for an eye examination. 5. Prior to the March 22, 2007 examination, CD asked the cost for an examination, arid was informed by Dr. Pieschke’s staff that the cost for an examination was sixty dollars ($60.00). 6. On or about March 22, 2007, prior to being seen by Dr, Pieschke, CD informed Dr. Pieschke’s staff that she did not have any separate vision insurance coverage, | 7. Dr. Pieschke’s staff asked CD for her medical insurance information, and CD provided same, 8, CD believed that Dr. Pieschke required her medical insurance card for record keeping purposes. 9, At the conclusion of the examination, CD paid a total of sixty-four dollars and fifty-one cents ($64.51) for the examination. 10. Dr. Pieschke billed CD’s medical insurance carrier (Blue Cross/Blue Shield of Florida) for a comprehensive/high eye examination under CPT (Current Procedural Terminology) code 99205. 11, CPT code 99205 indicates an office visit for the evaluation and management of a new patient, which requires three key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. Usually, the presenting problems are of high severity. DOH v. Glenn D, Pitschke, O.D. 2 Case No. 2008-23824 | Nov 4 2009 10:31 NOW-G4-2889 18:82 FL DEPT OF HEALTH 856 488 1855 Pa? 12. At best, CD's medical records support a moderate complexity level and a moderate level of risk. 13. CD's medical records indicated “possible early age related macular degeneration changes;” however, there were no notations in the examination of CD’s macula which indicated any such changes, 14, CD's examination indicated “even pigment,” and no physical findings were identified in the medical records to support early age related macular degeneration as a diagnosis. | 15. Dr. Pieschke indicated in CD's medical records “Fortifeye Complete” as a treatment for CD's undiagnosed early age related macular degeneration. 16. Dr. Pieschke‘s billing records identified an ICD-9 (International Classification of Diseases) diagnosis code of 366.17, 17. ICD-9 code 366.17 relates to varying levels of cataract diagnoses. 18. Dr, Pieschke’s advised CD purchase “Fortify Complete” (aka Fortifeye Vitamins) for an additional charge of one hundred twenty dollars ($120.00), in order to treat a disease (early age related macular degeneration) that Dr. Pieschke’s medical records did not indicate for CD. 19. Dr. Pieschke is an associate of Dr. Michael Lange (Dr. Lange) at one or more locations of Lange Fye Care & Associates or the Lange Eye Institute. 20. Dr. Lange claims to have “developed [the] nutrient-based vitamin formulas” known as “Fortifeye Vitamins,” and sits as Chairman of that company's Board of Directors. DOH v, Glenn D. Pieschke, 0.D. 3 Case No. 2008-23824, Nov 4 2009 10:31 NOW-G4—-2889 18:82 FL DEPT OF HEALTH 856 488 1855 P.@8 21. — Dr. Pieschke sits as a member of Fortifeye Vitamins’ “Advisor Group.” 22. Dr, Pieschke did not advise CD of any professional or financial connection Dr. Pieschke, or his associate Dr. Lange, might have to the Fortifeye Vitamin company prior to CD’s purchase of the “Fortifeye Complete” vitamins which Dr, Pieschke indicated as a treatment for early age related macular degeneration. COUNT 23. The Department re-alleges and incorporates paragraphs one (1) through twenty-two (22) as if fully set forth in this count. 24, — Pursuant to Section 463.016(1)(t), Florida Statutes (2006), a licensee is subject to discipline for violating any provision of this chapter or chapter 456, or any rules adopted pursuant thereto. 25. Rule 64B13-3.010(3), Florida Administratvie Code, states that an optometrist shail provide that degree of care which is full and complete, consistent with the patient conditions presented, the professional competency of the optometrist, and the scope of practice of optometry. 26. Dr. Pieschke indicated in CD’s medical records “Fortifeye Complete” as a treatment for CD's early age related macular degeneration, even though CD's examination indicated “even pigment,” and no physical findings were identified in the medical records to support early age related macular degeneration as a diagnosis. 27. Dr. Pieschke billed CD's insurance carrier using ICD-9 Code 366.17, indicating varying levels of cataracts, but failed to bill the insurance carrier any ICD-9 code indicating early age related macular degeneration. DOH v, Glenn D, Pieschke, O.D, : 4 Case No, 2008-23824 Nov 4 2009 10:31 NOW-G4—-2889 18:82 FL DEPT OF HEALTH 856 488 1855 P.@9 28. Based on the foregoing, Respondent violated Section 463.016(1)(t), Florida Statutes (2006), as defined by Rule 64B13-3.010(3), Florida Administrative Code, by advising or allowing CD to purchase “Fortifeye Complete” vitamins as a treatment for early age related macular degeneration, which was inconsistent with the condition for which CD presented. COUNT 2 29, The Department re-alleges and incorporates paragraphs one (1) through twenty-two (22) as if fully set forth in this count, 30. Pursuant to Section 463.016(1)(t), Florida Statutes (2006), a licensee is subject to discipline for violating any provision of this chapter or chapter 456, or any rules adopted pursuant thereto. , 31. Section 456.072(1)(n), Florida Statutes (2006), provides that a licensee is subject to discipline for exercising influence on the patient or client for the purpose of financial gain of the licensee or a third party. 32. Dr. Pieschke advised, and CD purchased, “Fortify Complete” vitamins for an additional charge of one hundred twenty dollars ($120.00), in order to treat a disease (early age related macular degeneration) that Dr. Pieschke’s medical records did not indicate for CD. 33. Dr, Pieschke is an associate of Dr. Michael Lange at one or more locations of Lange Eye Care & Associates or the Lange Eye Institute. DOH v. Glenn D. Pieschke, O.D. 3 Case No. 2008-23824 Now 4 2009 10:32 NOW-G4—-2889 18:82 FL DEPT OF HEALTH 856 488 1855 P.1a 34. Dr. Lange claims to have “developed [the] nutrient-based vitamin formulas” known as “Fortifeye Complete,” and sits as Chairman of that company’s Board of Directors. 35. Dr. Pieschke sits as a member of Fortifeye Vitamins’ “Advisor Group.” 36. Dr. Pieschke did not advise CD of any professional or financial connection Dr. Pieschke, or his associate Dr. Lange, might have had to the Fortifeye Vitamin company prior to CD’s purchase of the “Fortifeye Complete” vitamins, which Dr. Pieschke indicated as a treatment for early age related macular degeneration, even though nothing in CD's medical records indicated a diagnosis of early age related macular degeneration. 37. Based on the foregoing, Respondent violated Section 463.016(1)(t), Florida Statutes (2006), by violating Section 456.072(1)(n), Florida Statutes (2006), in that he exercised influence over CD for the purpose of financial gain for himself or a third party in one or more of the following ways: (a) by advising or allowing CD to purchase “Fortifeye Complete” vitamins as, a treatment for early age related macular degeneration, which was inconsistent with the condition for which CD presented; or (b) by failing to inform CD prior to her purchase of “Fortifeye Complete” of any professional or financial connection he or any of his associates had to the Fortifeye Vitamin company. COUNT 3 DOH v. Glenn D. Piéschke, O.D. 6 Case No. 2008-23824 Now 4 2009 10:32 NOW-G4—-2889 18:83 FL DEPT OF HEALTH ; 856 488 1855 P.ii 38. The Department re-alleges and incorporates paragraphs one (1) through twenty-two (22) as if fully set forth in this count. 39, Pursuant to Section 463.016(1)(), Florida Statutes (2006), a licensee is subject to discipline for willfully submitting to any third-party payor a claim for services which were not provided to a patient. 40. Dr. Pieschke billed CD’s medical insurance carrier (Blue Cross/Blue Shield of Florida) for a comprehensive/high eye examination under CPT (Current Procedural Terminology) code 99205. 41, CPT code 99205 indicates an office visit for the evaluation and management of a new patient, which requires three key components: a comprehensive history; a comprehensive examination; and mecical decision making of high complexity. Usually, the presenting problems are of high severity. 42. At best, CD’s medical records support a moderate complexity level and a moderate level of risk. 43. Based on the foregoing, Respondent violated Section 463.016(1)(j), Florida Statutes (2006), by willfully billing CD’s insurance carrier for services not provided to CD. when he billed CPT coder 99205 for a comprehensive/high examination, when CD’s medical records support no more than a moderate complexity level and a moderate level of risk. WHEREFORE, Petitioner requests that the Board of Optometry enter an order imposing one or more of the following penalties: permanent revocation or suspension of DOH v. Glenn D. Pieschke, O.D. 7 Case No, 2008-23824 Now 4 2009 10:32 NOW-G4—-2089 18:83 FL DEPT OF HEALTH 856 488 1855 P.i2 Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. ) SIGNED this Or” aay of JON, 2009. Ana M. Viamonte Ross, M.D., M.P.H. ong neral h oes ne CLERK: Cingcle Bit Socom, paTe__2/a7foq _ ‘C. Khai Patterson, Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 _ Tallahassee, Florida 32399-3265 ‘Florida Bar No.: 0023221 (850) 922-2268 Telephone (850) 922-2382 Facsimile PCP Panel Members: Presnell, Underhill, McClane PCP Date: July'22, 2009 DOH +. Glenn D. Pisschke, O.D. 8 Case No. 2008-23824 Now 4 2009 10:32 NOW-G4—-2089 18:83 FL DEPT OF HEALTH 856 488 1855 P.13 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed. DOH v. Glenn D. Pieschke, ©,D, 9 Case No. 2008-23824

Docket for Case No: 09-006052PL