Genetic Testing Fraud Trend Attracts DOJ Attention

October 8, 2019 | Eric D. Fader | Fraud and Abuse | Litigation | Medicare and Medicaid | Telehealth

The U.S. Department of Justice (DOJ) recently announced fraud charges against 35 individuals in five federal districts for defrauding Medicare of more than $2.1 billion in medically unnecessary genetic testing. The announcement of the coordinated actions, which involved dozens of telemedicine companies and genetic testing laboratories, eight physicians and two nurse practitioners, was foreshadowed by a Fraud Alert that was discussed here.

The federal investigation was a joint effort of the DOJ’s Criminal Division, the Department of Health and Human Services’ Office of Inspector General, and the FBI. In the scheme, testing labs allegedly paid illegal kickbacks to physicians and nurses who worked with fraudulent telemedicine companies to induce them to refer Medicare beneficiaries for genetic tests for cancer. The DOJ said the test results were worthless, or sometimes not provided at all.

“One of the largest health care fraud schemes ever charged” (according to the DOJ press release) targeted elderly and disabled patients in Florida, Georgia, Louisiana, and Texas.

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