Genetic testing company pays $1.99 million for medically unnecessary tests

by Ben Vernia | February 18th, 2019

On February 9, the Department of Justice announced that a Vancouver, BC – based genetic testing company has agreed to pay nearly $2 million to settle a whistleblower’s allegations that it caused the submission of claims for medically unnecessary tests. According to DOJ’s press release:

The Justice Department announced today that GenomeDx Biosciences Corp. (GenomeDx) has agreed to pay $1.99 million to resolve allegations that it violated the False Claims Act, 31 U.S.C. §§ 3729 et seq., by submitting claims to Medicare for the Decipher® post-operative genetic test for prostate cancer patients.  GenomeDx is a genetic testing laboratory headquartered in Vancouver, British Columbia, with operations based in San Diego.

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The United States alleged that GenomeDx knowingly submitted claims for the Decipher test to Medicare between September 2015 and June 2017 that were not medically reasonable and necessary because the prostate cancer patients did not have risk factors necessitating the test, including pathological stage T2 disease with a positive surgical margin, pathological stage T3 disease or rising Prostate-Specific Antigen (PSA”) levels after an initial PSA nadir.

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The government announced that the whistleblowers in the case will receive $348,316.50 (a 17.5% relators’ share).

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