Biotech Whistleblower Case Settles for Approximately $2 million – Unnecessary Services
GenomeDx Biosciences, a biotechnology company in San Diego, has settled allegations that it improperly billed Medicare and private insurance companies for unapproved genomic testing. As part of the settlement, GenomeDx will pay $1.99 million to the United States. The two whistleblowers who were represented will together receive almost $350 thousand as a whistleblower award (before fees).
The case was filed under the federal False Claims Act by Whistleblower Law Firm Brown, LLC, a firm led by former FBI Special Agent Jason T. Brown. Attorney Brown commended the hard work his team and the government put in, noting the work of Assistant United States Attorney Joseph Price of the San Diego Division, Doug Rosenthal from Main Justice, and others from the DOJ and US Attorney’s office who worked on the case. Internally, whistleblower lawyers Jason T. Brown, Benjamin Lin and Patrick Almonrode, and staff member Angiee Rosario, contributed to the result, as well as other staff members at the firm.
Whistleblowers are the linchpin of the False Claims Act. Courageous individuals who blow the whistle on fraud stand to benefit, but more importantly help hold accountable institutions and individuals whose fraud make medical care more expensive for all.
The case against GenomeDx focused on their billing for a genetic test for prostate cancer. The complaint alleged that the company conducted and billed Medicare for unnecessary test, including even tests performed on tissues of people who had already unfortunately passed on.
“The Department of Justice is committed to ensuring that Medicare reimburses costs for laboratory testing that are reasonable and necessary for the individual patient,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division, in a separate press release. “Medically unnecessary and unproven testing increases costs for federal health care programs.”
“The message is clear, if you take advantage of programs like Medicare, you will be held accountable,” said John Brown, FBI Special Agent in Charge of the San Diego Field Office.
Jason T. Brown encouraged other individuals who know of Medicare Fraud, Medicaid Fraud, or Insurance Fraud to contact his office to speak with his whistleblower team. According to Brown, “It’s estimated that 10% or more of health care costs are due to fraud, and the more courageous individuals that come forward, the better it is for everyone.” The case is at No. 17-CV-1959 (S.D. Cal.) The Department of Justice press release may be found here: https://www.justice.gov/opa/pr/genetic-testing-company-agrees-pay-199-million-resolve-allegations-false-claims-medicare the claims resolved by the settlement are allegations only, and there has been no determination of liability.