Earlier today, Exagen Inc. consented to pay $653,143 to settle allegations of kickback violations according to the U.S. Attorney for the District of Massachusetts. The California-based company, renowned for diagnostic tests for the treatment of autoimmune conditions, admitted accusations of paying certain physicians for patient blood draws. They did this under specimen processing agreements they committed with these doctors. Exagen then billed federal health care programs, including Medicare, for tests facilitated after receiving orders from the physicians.
The alleged violations transpired after Exagen was warned, on June 25, 2014, by a Special Fraud Alert from the HHS-OIG. It specifically highlighted the significant risk of fraud caused by the practice of paying physicians specimen processing fees. The current settlement, dated October 17th, derived from allegations initially brought under the qui tam provisions of the False Claims Act by a whistleblower. These provisions allow individuals, known as relators, to file a lawsuit on behalf of the government and share in any recovery, where the whistleblower in question will receive 16 percent of the recovery amount.
Announcing this the decision were the Acting United States Attorney Joshua S. Levy, HHS-OIG Special Agent in Charge Roberto Coviello, and Christopher F. Algieri, Special Agent in Charge of the Department of Veterans Affairs, Office of the Inspector General, Northeast Field Office, with the matter subsequently handled by Assistant U.S. Attorneys Abraham R. George, Chief of the Affirmative Civil Enforcement Unit, and Alexandra Brazier of the Affirmative Civil Enforcement Unit.
