Kickbacks for genetic test referrals has become a focus of recent federal enforcement action. The most recent case involves three doctors and a cardiology practice that allegedly accepted bribes from a now-bankrupt genetic testing company in the Seattle area. The DOJ claims that Natural Molecular Testing Corporation (NMT) paid doctors as much as $10,000 per month in consulting fees in exchange for referrals of high-complexity tests that were billed to Medicare. Rather than risk a trial, three doctors and the practice, all based in Alabama, agreed to settle the claims for a combined $1.1 million.
In 2015, after entering Chapter 11, NMT settled claims related to its part in the scheme for $71.1 million. Claims against the lab included not only payment of kickbacks but also the medical necessity of the tests performed, a lack of documentation around the completion of the testing, multiple billing claims for the same date of service and use of the test for screening purposes (which Medicare doesn’t cover).
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