Genetic Testing Lab Pays $2.5 Million to Settle Kickback and False Claims Charges
Case: The feds accused a California-based molecular diagnostics firm of working with a marketing firm to carry out a scheme to falsely bill Medicare for medically unnecessary genetic tests performed on patients of 76 nursing homes generated via paid referrals. Rather than risk a trial, the firm agreed to settle the case for $2,538,000. Significance: The DOJ claims that the lab agreed to pay the marketing firm a cut on the Medicare reimbursement for every genetic test referred by the firm’s clients. If Medicare didn’t pay for the test, the firm didn’t get the fee. The firm then teamed up with a Wisconsin nursing homes owner and operator to identify Medicare patients the firm could approach to obtain buccal cell samples that could be sent to the lab for genetic testing. In subsequently billing Medicare for the tests, the lab added False Claims Act violations to its kickback offenses. For its part, the nursing home operator has agreed to pay $1 million to settle claims arising from its role in the scheme.
Case: The feds accused a California-based molecular diagnostics firm of working with a marketing firm to carry out a scheme to falsely bill Medicare for medically unnecessary genetic tests performed on patients of 76 nursing homes generated via paid referrals. Rather than risk a trial, the firm agreed to settle the case for $2,538,000.
Significance: The DOJ claims that the lab agreed to pay the marketing firm a cut on the Medicare reimbursement for every genetic test referred by the firm’s clients. If Medicare didn’t pay for the test, the firm didn’t get the fee. The firm then teamed up with a Wisconsin nursing homes owner and operator to identify Medicare patients the firm could approach to obtain buccal cell samples that could be sent to the lab for genetic testing. In subsequently billing Medicare for the tests, the lab added False Claims Act violations to its kickback offenses. For its part, the nursing home operator has agreed to pay $1 million to settle claims arising from its role in the scheme.
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