Baba

MEMORANDUM ***

Dr. Stephanie Baba is a California-licensed optometrist who provided services for nursing home patients in 1997. After she sought reimbursement from Medicare, her insurance carrier audited her to ensure that she had properly billed the work she had done. The auditor, Dr. John G. Rosten, had examined a random sample of her patients and found that Baba had submitted improper billing codes, inadequately maintained records, failed to document the medical necessity of some services, and failed to obtain authorization for optometric services from an attending physician in some cases. He concluded that Baba departed from the standard of care, and that her actions constituted unprofessional conduct.

Rosten’s report led to concurrent investigations by the California Department of Consumer Affairs, Board of Optometry, and Medicare officials. The Board of Optometry issued an Accusation to Baba, charging her with (1) using “cappers” and “steerers” in violation of Business and Professions Code sections 3090, 3100, and 3103, and (2) obtaining fees by fraud and misrepresentation because she improperly used Current Procedural Terminology (CPT) billing code 99303 1 in seeking re…