United States Attorney David Metcalf announced that Genexe, LLC, Immerge, Inc., and two executives have agreed to settle allegations of fraudulent Medicare claims for $6 million. The accusations involve violations of the False Claims Act by causing Medicare to pay for unnecessary genetic tests tainted by kickbacks.
Genexe, LLC, previously operating as Genexe Health, was a Delaware corporation based in Colorado. It stopped operating but had been involved in genetic and pharmacogenetic profiling. Immerge, Inc., also defunct, was Genexe's parent company and operated as an outsourced sales marketing entity.
The implicated executives, Jason Green and Jason Gross, held leadership roles at both companies, with Green as CEO and Gross as COO, owning stakes in both entities.
The allegations suggest these companies engaged in schemes from July 2018 to December 2019, causing improper Medicare claims for genetic tests that were neither needed nor covered under Medicare regulations. They participated in a network involving laboratories and telemedicine providers, where Medicare was billed at rates exceeding $6,000 per test, generating revenue for Genexe from Medicare reimbursements.
The scheme involved marketing genetic tests to Medicare beneficiaries at no cost to the individuals, employing independent contractors to recruit patients and collect DNA samples, which were processed and billed to Medicare. The process included paying kickbacks to obtain necessary physician orders and manage the genetic testing.
According to U.S. Attorney Metcalf, the settlement reflects commitment to investigating fraud in federal healthcare programs, while Maureen Dixon from the U.S. Department of Health and Human Services, Office of Inspector General, highlighted the need for medical testing to benefit patient care rather than personal gain.
The settlement also addresses claims in whistleblower lawsuits under the False Claims Act, allowing private parties to file lawsuits for false claims for a share of the recovery. Relators in these lawsuits will receive approximately $1.3 million from the settlement.
The matter was handled by Assistant U.S. Attorney Mark J. Sherer and Auditor Denis J. Cooke. It is important to note that the resolved claims are allegations with no determination of civil liability made.
