Laser Outfit Gets Praised, Prosecuted.

The state's biggest laser eye surgery chain has received accreditation from one of the nation's most respected health care organizations, even as the chain and its owner await trial on charges of bilking the federal Medicare program.

The Joint Commission on Accreditation of Healthcare Organizations, which accredits 19,000 organizations nationwide, awarded Glendora-based Laser Eye Cen-ter its second highest level of certification: accreditation with recommendations for improvement.

But the center -- which has been touting the accreditation to the media -- and its owner, Dr. Antoine Garabet, are scheduled to go on trial April 17 in Los Angeles federal court on 22 charges of defrauding Medicare. The company is accused of billing for laser eye surgeries that were not performed and over-billing for others.

Charlene Hill, spokesman for the joint commission, would not comment directly on the accreditation, which was given Dec. 19, since the center is still responding to the commission's recommendations. But she said that, as a matter of course, financial issues are not considered during the commission's reviews.

"When we go out and evaluate an organization, we evaluate them according to our standards, which is delivery of care and patient safety," Hill said.

The center and Garabet were indicted Sept. 27 by a federal grand jury in Los Angeles on charges stemming from alleged improprieties committed over a two-year period starting in 1995.

Garabet, who is free pending trial, is accused of billing Medicare for laser eye surgeries that were never done, going so far as to bring people into his office and "going through the motions" of performing surgery. He also allegedly falsified paperwork to raise Medicare reimbursement rates on other surgeries.

If convicted, Garabet faces a possible prison term, while the center could be fined. At the time of the indictment, Alejandro Mayorkas, then the U.S. Attorney for Los Angeles, said the actions were taken out of "pure greed."

Attorney Richard Marmaro, who is representing Garabet, disputed the charges, calling them a highly technical dispute over Medicare payments.

"Dr. Garabet has pleaded not guilty and intends to vigorously contest the charges in court," said Marmaro. "Accreditation and standards of care have nothing to do with what is involved in the trial."

Garabet, since founding the company in 1994, has built a chain of 23 centers in the burgeoning field of laser eye surgery, which allows patients suffering from nearsightedness and other conditions to ditch their glasses and contacts.

In recent years, as more and more surgeons enter the field, it has become highly competitive, driving down prices but also giving rise to reports of complications that can threaten sight.

Garabet declined to be interviewed last week, but in a press release issued late last month the doctor cited the accreditation as proof that the company's patients are receiving the best eye care.

"The accreditation from JCAHO delivers a strong message about our commitment to providing our patients with the highest quality eye care available," Garabet stated.

The center is also touting itself as the only standalone laser eye center in the nation to receive an accreditation from the organization.

Hill said she could not verify that claim because of the decentralized nature of the commission's accreditation program. She also said that, while accreditation teams give organizations a "top-to-bottom" review, the team does nor review surgical outcomes.

"We check to see: Do they assess patients? Do they have information on patient's medical histories?" she said. "It's really what they are doing to protect the safety of the patient."

But Dr. James Salz, a clinical professor of ophthalmology at USC who has an Encino laser eye practice, discounted the accreditation.

"Most eye centers won't even bother with it, because we don't need it," said Salz, who has served as an expert witness in two malpractice cases brought against Garabet, including one in trial at Pomona Superior Court.

According to Los Angeles County Superior Court records, Garabet has been sued more than 20 times since 1994. One $48,000 malpractice judgment was recorded against him by the California Medical Board, stemming from a 1999 case.

Darren Roberts, a spokesman for the center, said that case stemmed from an eyelid surgery and not a laser eye surgery. Most of the other cases were dismissed, he said, and the number of lawsuits is minimal, considering the center operated on about 35,000 pairs of eyes in 2000 alone.

Roberts also brushed off Salz's comments as those of a competitor jealous of Garabet' s success.

"It's just a very competitive industry in this city," he said.