On May 21, the U.S. Attorney for the Eastern District of Tennessee announced that Agendia, Inc., a global molecular diagnostics company that offers genomic testing designed to profile certain types of breast cancer, agreed to pay the government at least $3,250,000 to settle allegations that it violated the False Claims Act (FCA).
The settlement stems from two separate qui tam lawsuits filed by whistleblowers, Dr. Raymond Brig and Lance Albertson. The whistleblowers are set to receive $296,725 of the proceeds from the settlement and may eventually receive as much as $921,725.
The allegations centered around Agendia’s billing of Medicare, Medicaid, and other government payors for a lab test called MammaPrint.
According to the government, “the MammaPrint claims were false because Agendia caused physicians and providers (referring providers) to order MammaPrint testing that was not reasonable or medically necessary through standing or automatic orders” and “certain claims submitted by Agendia were deceptive because they were tainted by the payment of illegal remuneration to referring providers who ordered the tests – including extravagant dinners, excessive or improper honoraria, gift cards, and payments per referral or monthly flat rate payment arrangements.”
“The Medicare and Medicaid programs deliver coverage for vital medical and diagnostic testing to beneficiaries and recipients,” said U.S. Attorney Francis M. Hamilton III for the Eastern District of Tennessee. “False...
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