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$2.5M settlement reached in genetic-testing scheme

By: Michaela Paukner, [email protected]//January 20, 2021//

$2.5M settlement reached in genetic-testing scheme

By: Michaela Paukner, [email protected]//January 20, 2021//

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A California company has agreed to a $2.5 million settlement to resolve allegations that it had paid a marketing company to refer it genetic testing for Wisconsin nursing-home patients.

AutoGenomics made a deal with a marketing company in April 2013 and March 2015 to pay a monetary kickback for each test that was ordered by the marketing company’s clients and reimbursed by Medicare, according to Scott C. Blader, U.S. attorney for the Western District of Wisconsin. The dollar amount was calculated using a percentage or fixed amount of Medicare’s reimbursement for each test.

Prestige Administrative Services, which owns and operates residential nursing homes in Wisconsin and other states, gave the marketing company information about its Medicare patients and allowed access to its patients for genetic testing in 2014 and 2015. Prestige settled its alleged role in the kickback scheme for nearly $1 million for causing the submission of medically unnecessary tests. It did not admit liability.

The federal government accused AutoGenomics of violating the Anti-Kickback statute and the False Claims Act for testing performed on patients at 76 nursing homes throughout the country. AutoGenomics settled the claims for nearly $2.54 million, Blader said on Jan. 11. There has not been a determination of liability.

State and federal authorities worked together to uncover the fraud. Blader said state surveyors provided “crucial assistance” to identifying facts that led to the federal investigation and the settlement.

The settlement was the result of a joint investigation conducted by the U.S. Department of Health & Human Services and the U.S. Attorney’s Office for the Western District of Wisconsin. The alleged factual basis for the investigation was discovered during survey work performed by professionals at the Wisconsin Department of Health Services Division of Quality Assurance. The prosecution of this case was handled by Assistant U.S. Attorney Leslie K. Herje.

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