By the Constantine Cannon Whistleblower Team

On April 23, the government announced that Genexe LLC, its marketing company Immerge, Inc., and two of its owners, Jason Green and Jason Gross, will pay $6 million to settle allegations that they violated the False Claims Act and Anti-Kickback Statute.

The now-defunct Genexe once billed itself as a “one-stop-shop” for genetic and pharmacogenetic profiling, marketing itself as “involved in every aspect of the patient screening process, from the collection of samples to laboratory processing.” In reality, the company operated a high-volume kickback scheme bilking Medicare out of millions of dollars.

According to the government, Genexe allegedly targeted Medicare beneficiaries for unnecessary genetic testing, hiring untrained independent contractors to collect patient information and DNA samples at malls, churches, and senior centers. To drive referrals, they paid kickbacks to incentivize doctors to order medically unnecessary genetic and pharmacogenetic tests. Genexe then sent the samples to labs, which in turn paid Genexe kickbacks of up to $2,000 per sample.

This case was brought by four whistleblowers under the qui tam provisions of the False Claims Act, allowing private parties (or relators) to file lawsuits on behalf of the government and receive up to 30% of any recovery. As part of this settlement, the relators will receive $1.32 million altogether, roughly 22% of the recovery.

U.S. Attorney Metcalf stated: “Genetic testing fraud preys on the fears of patients, and it wastes taxpayer dollars by spending limited funds on medically unnecessary or nonexistent tests. This settlement shows we will work with our law enforcement partners to investigate fraud, waste, and abuse in federal healthcare programs and will use every tool available to recover improperly paid taxpayer funds.”

Healthcare Fraud and Kickback Schemes

Healthcare fraud and kickback schemes remain a threat to government funded programs. These schemes occur at all levels of the healthcare system from individual medical facilities to executive offices of global pharmaceutical companies.

Kickback schemes take many forms, such as a drug company paying kickbacks to pharmacies to get them to switch patients’ prescriptions, and diagnostic labs like Genexe incentivizing doctors to order unnecessary tests. Violations of the Anti-Kickback Statute and Stark Law can be reported by whistleblowers under the False Claims Act.

What Role do Whistleblowers Play in Uncovering Medicare Fraud and Kickback Schemes?

Whistleblower partner Marlene Koury highlighted the importance of whistleblowers in uncovering fraud: “Whistleblowers help maintain the integrity of the system, protect patients, and save taxpayers’ money. The United States enforces Medicare fraud and violations of the Anti-Kickback and Stark laws to prevent waste of government funded programs.”

Whistleblowers are instrumental in identifying and sharing any knowledge they might have of fraud. One example of an insider-turned-whistleblower could be an employee becoming aware of doctors knowingly, willfully receiving, offering, or paying for referring individuals under a federal healthcare program that violates the Anti-Kickback Statute.

If you would like more information on what it means to be a whistleblower, believe you have information relating to False Claims Act violations or healthcare fraud, please contact us so we can connect you with a member of the experienced Constantine Cannon whistleblower lawyer team for a free and confidential consultation.

 

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United States Attorney’s Office Eastern District of Pennsylvania, Press Release

Read Genexe and Its Entities Will Pay $6M to Settle False Claims Act Allegations, Case Brought by Four Whistleblowers at constantinecannon.com