In a follow up to last month’s OIG fraud alert regarding genetic testing scams, a federal jury found the owner of a Tampa, Florida-area medical marketing company guilty for his role in an over $2.2 million Medicare fraud scheme involving the payment of kickbacks and bribes to medical clinics. The problematic payments were in exchange for the referral of DNA swabs, to the Miami-based lab, that were obtained from Medicare beneficiaries.
This case confirms previous suspicions about the existence of these fraudulent schemes and further illustrates the need for health care providers to review the relevant state and federal laws concerning genetic testing, including the federal Anti-Kickback Statute, state-specific Anti-Kickback Statute, the federal Stark Law, and other applicable laws and rules. Some of the applicable laws potentially expose providers to criminal prosecutions while almost all includes monetary penalties, including fines, as well as possible exclusion from participation in federal health care programs.
A thorough internal review of company policies, combined with the development of a set of robust standard operating procedures, is a valuable process to avoid potential enforcement action.
Frier Levitt counsels and represents a broad panoply of health care stakeholders, including physicians, pharmacies, drug and device manufacturers, health care companies, private equity, and other participants in healthcare transactions. Our interdisciplinary team of regulatory, transactional, and litigation attorneys also represent and defend health care providers in federal and state enforcement actions and self-disclosures. Additionally, Frier Levitt advises clinical laboratories involved in genetic testing across the country in creating compliant marketing programs and assists these facilities in submitting proper claims. Contact Frier Levitt to speak with an attorney today.