The United States settled a False Claims Act case brought by two of our clients against Genexe, LLC d/b/a Genexe Health, its parent company Immerge, Inc., and two of the companies’ control persons and owners, Jason Green and Jason Gross. Under the terms of the Genexe settlement, Genexe, Immerge, Gross and Green will collectively pay $6 million plus interest to resolve the allegations of genetic testing fraud.
The fraudulent conduct was brought to light by multiple FCA qui tam cases filed by several whistleblowers, including two of our clients. The whistleblowers collectively will receive a relators’ share award of approximately $1.3 million from the settlement. Defendants are also paying the Relators’ reasonable attorneys’ fees and costs.
After investigating the claims raised in the relators’ FCA qui tam complaints, the United States alleged that during 2018 and 2019, Genexe, Immerge, Green, and Gross assisted with and caused to be submitted false claims to Medicare for CGx and PGx tests that were not medically necessary and that were procured through kickbacks. offered and paid to a network of independent contractors (IBOs), medical laboratories, medical providers, and telemedicine healthcare providers. Medicare does not cover clinical laboratory tests that are not medically necessary or that are tainted by kickbacks.
Genexe would obtain the genetic samples (usually from a cheek swab of saliva) for the CGx and PGx tests along with Medicare beneficiaries’ protected health care information and a physician order for the genetic test and send the Medicare beneficiary’s specimen and information to the laboratories for testing. Laboratories then billed Medicare for the fraudulent genetic testing and were regularly reimbursed at rates exceeding $6,000 per test. Once Medicare paid the medical laboratory, Genexe would receive a portion of the Medicare reimbursement funds from the laboratory; initially, Genexe was paid about $800 per swab, but later was paid amounts ranging from $1,000 to $2,000 depending on the type of genetic test.
This settlement is particularly notable because Jason Green and Jason Gross, two individual officers and owners of the companies, were held accountable by the United States and will collectively pay the settlement amount along with the companies. Green and Gross served, respectively, as the Chief Executive Officer and Chief Operating Officer of Genexe and Immerge, and they controlled and had ownership interests in the companies.
In the press release announcing the settlement, government officials emphasized the importance of identifying and ending genetic testing fraud scams.
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.
United States Attorney David Metcalf
Medical professionals should only order testing which would benefit individual patient care, not for personal gain.
Maureen Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services
Whistleblower Law Collaborative commends the outstanding efforts of their clients and the government prosecutors.
It was a privilege to represent two clients who were willing to come forward to alert the government to a national fraud scheme which preyed on elderly victims and cost taxpayers millions of dollars. The settlement announced today is a testament to the skill, resolve, and stamina of an outstanding team of government attorneys and investigators who put an end to that scheme and held those who profited accountable for their actions.
Bruce C. Judge, Partner, Whistleblower Law Collaborative
This is the third settlement of a genetic testing fraud FCA case brought by a client of WLC. We began sounding the alarm about genetic testing scams in 2018. Without the courage of whistleblowers, scams like this would go undetected.