In a telling blow against fraudulent healthcare practices, two Colorado-based companies and their key executives have agreed to pay $6 million as settlement for allegations of conducting a genetic testing scheme that milked Medicare. According to the U.S. Attorney's Office, Genexe, LLC, and Immerge, Inc., along with Jason Green and Jason Gross, faced accusations of violating the False Claims Act by billing for unnecessary medical tests influenced by kickbacks.
Genexe, now defunct, was a marketing firm that touted its involvement in "every aspect of the patient screening process" for genetic and pharmacogenetic profiling, reported to have conducted their business in the Eastern District of Pennsylvania, among other places. Their parent company, Immerge, similarly out of operation, was described as providing "customized sales and marketing solutions" to major companies. The two firms, operated by Green and Gross as CEO and COO respectively, orchestrated a kickback scheme involving telemedicine providers and medical laboratories that resulted in billing Medicare for unneeded genetic tests, as detailed in the allegations.
Specifically, from July 2018 to December 2019, the companies engaged Independent Business Operators (IBOs) with no medical expertise to collect DNA via cheek swabs and personal health information from Medicare beneficiaries at various public locations. These samples, labeled and packed, were shipped off to Immerge before being forwarded for testing. The U.S. Attorney's Office, as documented, argues that these were exercises in futility, designed to exploit Medicare for tests that had no real medical necessity.
Adding to the woes of the accused, their settlement also wraps up claims in whistleblower lawsuits filed under the False Claims Act, zooming in on their illicit practices and subsequent recoupment of Medicare funds. Four relators in the cases United States ex rel. Shimi v. Genexe, LLC, et al., and United States ex rel. Covington v. Genexe, LLC, et al., will receive around $1.3 million combined. U.S. Attorney David Metcalf underscored the resolve of his office "to investigate fraud, waste, and abuse in federal healthcare programs" and to utilize "every tool available to recover improperly paid taxpayer funds" according to the statement.
The gravity of such schemes is not lost on officials like Maureen Dixon, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), who emphasized the sanctity of patient care over personal gain. "Medical professionals should only order testing which would benefit individual patient care, not for personal gain," Dixon stated on the U.S. Attorney's Office, confirming the ongoing vigilance against kickback-driven services. Together with HHS-OIG, the U.S. Attorney's Office and their law enforcement partners remain committed to evaluating and pursuing allegations of healthcare-related corruption.
