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ENFORCEMENT

Doctors pay $1.1 million to settle genetic test kickback claims

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).


Editor’s picks:

Miami medical office manager convicted of Medicare fraud


OIG issues genetic testing fraud alert


Feds target doctors who took kickbacks


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