False Claims Counsel

On January 10, the Department of Justice announced that a New Jersey-based clinical laboratory and its owner has agreed to settle civil fraud allegations for a combined federal and state amount exceeding $13 million. According to DOJ’s press release:

Clinical laboratory RDx Bioscience Inc. (RDx), of Kenilworth, New Jersey, and its owner and Chief Executive Officer Eric Leykin, of Brooklyn, New York, have agreed to pay to the United States $10,315,023 to resolve False Claims Act allegations involving illegal kickbacks and medically unnecessary laboratory testing. RDx and Leykin will pay an additional $2,934,977 to the State of New Jersey, which jointly funded claims paid by the New Jersey Medicaid program. RDx and Leykin have agreed to cooperate with the Justice Department’s investigations of, and litigation against, other participants in the alleged schemes.

* * *

The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and other federally funded healthcare programs. The Anti-Kickback Statute is intended to ensure that medical providers’ judgments are not compromised by improper financial incentives and are instead based on the best interests of their patients. Claims that are knowingly submitted in violation of the Anti-Kickback Statute are ineligible for payment and can violate the False Claims Act. 

The settlement announced today resolves allegations concerning five types of kickbacks paid to induce referrals to RDx for laboratory testing. First, from 2018 to 2022, RDx and Leykin allegedly paid commissions based on the volume and value of Medicare and Medicaid referrals to independent contractor marketers to arrange for and recommend that healthcare providers order RDx laboratory tests. Second, from 2018 to 2022, RDx marketer Corum Group LLC allegedly paid healthcare providers thousands of dollars in purported management services organization (MSO) payments, which were disguised as investment returns but actually were offered to induce the providers to order RDx laboratory tests. Third, from 2017 to 2023, RDx marketers BeauMed Consultants LLC and Ralston Health Group Inc. allegedly paid thousands of dollars to healthcare providers that were disguised as consulting or medical director fees but were actually offered to induce orders, among other things, for RDx laboratory tests. Fourth, from 2019 to 2020, RDx marketer Seaworthy Recovery Services Inc. allegedly paid thousands of dollars in kickbacks to one or more principals of certain substance abuse recovery centers to induce their referrals to RDx for laboratory testing. Fifth, RDx and Leykin allegedly paid specimen collection fees to the staff members of referring healthcare providers to induce those providers to order RDx laboratory testing. The settlement resolves allegations that RDx and Leykin billed or caused Medicare and Medicaid to be billed for the tests despite paying or knowing of these kickbacks.

In addition, from 2017 to 2023, RDx and Leykin allegedly submitted or caused false claims to be submitted to Medicare and Medicaid for laboratory tests that were not reasonable and necessary; not covered because they were identical orders of urine drug testing panels for all patients within a clinician’s practice without individualized decision-making; or not covered because they were improperly duplicative of other claims for urine drug testing for the same date of service, the same patient, and the same drugs.

* * *

The case apparently arose from a government investigation, and not from a whistleblower’s qui tam complaint.