The DNA of Medicare Fraud & the False Claims Act

Genetic Testing Laboratory Pays $2 Million to Settle Allegations of Medicare Fraud The Justice Department announced a settlement last month with GenomeDx Biosciences Corp. (“GenomeDx”), a genetic testing laboratory based in Vancouver, British Columbia with offices in San Diego. GenomeDx agreed to pay nearly $2 million to resolve alleged violations of the False Claims Act. According to the complaint, GenomeDx committed Medicare fraud by submitting false claims for its “Decipher” post-operative genetic test. The Decipher test measures the activity of genes in prostate tumors to evaluate the risk of cancer recurrence. The qui tam action was brought by two whistleblowers, both of whom were former employees whose responsibilities included prior authorizations, billing and provider appeals. In the complaint, the United States and the relators asserted that the company’s conduct violated the False Claims Act, the Anti-Kickback Statute and the…

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