Skip to main content
Whistleblower Uncovers Cancer Genetic Testing Fraud
Table of Contents
You are sitting at your desk in the office, staring at orders for cancer genetic tests that you know were never requested by a patient’s doctor. Many of these patients will never see the results. The orders came from strangers, and they target people solely because of their Medicaid card. For a former Premier Medical employee, this was reality. She observed the marketing tables outside bus stops and at street corners. She knew Medicaid was being billed thousands of dollars for each unnecessary test. And she made the decision to blow the whistle.
Her decision set off a domino effect that ended in more than $114 million in settlements across Georgia, Colorado, and South Carolina. One insider’s courage turned the fraudsters’ strategy into a blunder, changing the game for good. Plus, since she properly invoked the False Claims Act she was eligible for a False Claims Act whistleblower reward up to $34.2 million.
$114.5 Million in Judgments and Settlements
In one of the largest health care fraud resolutions, the United States and the States of Georgia, Colorado, and South Carolina secured more than $114.5 million in judgments and settlements against defendants involved in a cancer genetic testing scheme. At the core was Premier Medical, Inc., a Greenville-based laboratory, and its owner who conspired to bill Medicaid for medically unnecessary cancer genetic (CGX) tests. Providers with no treating relationship to the patient ordered these tests. They were advertised through aggressive tactics that targeted low-income Medicaid recipients. The government brought the scheme to an end and displayed the potent impact of working with a whistleblower law firm.
The fraud did not unfold in boardrooms or medical offices. It unfolded on sidewalks and in dollar stores, where Medicaid patients were approached by marketers setting up tables in low-income neighborhoods promising “free cancer screenings.”
The catch? The patients’ doctors didn’t order the tests, and many of the recipients never received their results. Alternatively, telemedicine providers signed off on thousands of genetic test orders. Premier Medical and its partners received reimbursements in return as high as $12,000 per test.[1]
Speak with the Lawyers at Brown, LLC Today!
Over 100 million in judgments and settlements trials in state and federal courts. We fight for maximum damage and results.
Like in any sporting match, the balance shifted when someone read the rules and learned to fight fire with fire. A former Premier Medical employee came forward under the qui tam provisions of the False Claims Act. Her decision allowed the government to intervene and recover more than $114 million across three states. This case was not handled by Brown, LLC, who has a string of $100 million+ False Claims Act settlements, but there was some excellent advocacy by the firm that handled it along with the Department of Justice and United States Attorneys’ Office.
Whistleblower Awards Under the False Claims Act
Under the FCA, whistleblowers may be entitled to up to 30% of the recovery as a whistleblower award.[2] Having a trusted whistleblower lawyer can mean the difference between being a lone pawn or having a team standing behind you.
Brown LLC has built a national reputation for representing whistleblowers who uncover abusive fraud against government programs such as Medicare, Medicaid, and TRICARE. Our whistleblower law firm has helped insiders file cases under the False Claims Act to stop schemes that exploit patients.
Brown LLC’s Role in Major Whistleblower Recoveries
Our team has played a role in landmark recoveries, including a $32.5 million Medicare fraud settlement against Genomic Health, Inc., involving alleged manipulation of the 14-day rule for laboratory testing reimbursements.[3] Our attorneys represented one of the whistleblowers in that case, helping to bring critical information to light that led to a significant recovery for the government. The relator received more than $5 million as part of the resolution, reflecting the important role whistleblowers play in holding companies accountable. Brown LLC is proud to stand with individuals who step forward, and our work in cases like this underscores our commitment to protecting patients, taxpayers, and the integrity of federal programs.
False Claims Act, ch. 3730(d)(1), 31 Stat. (2022)
https://ifightforyourrights.com/news/brown-llc-obtains-a-32-5-million-false-claims-act-settlement/
