The United States alleged that Ocenture participated in a genetic testing fraud scheme with other marketers and clinical laboratories. As part of the alleged scheme, Ocenture solicited genetic testing samples from Medicare beneficiaries directly and through other marketers. Ocenture then paid physicians to falsely attest that the genetic testing was medically necessary and arranged for the laboratories to process the tests and receive reimbursement from Medicare, with a portion of that reimbursement being paid to Ocenture.
“The Anti-Kickback Statute prohibits paying or receiving remuneration for referring services paid for by federal health care programs,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department will hold accountable those who undermine the integrity of these programs by knowingly engaging in illegal kickback schemes that distort physician decision-making and waste taxpayer dollars.”
“Kickback schemes corrupt the clinical judgments of providers and may lead to unnecessary medical services paid for by taxpayers,” said U.S. Attorney for the Middle District of Florida Roger Handberg. “The resolution of this civil case confirms our district’s resolve in protecting our federal health programs from these fraudulent practices.”
“Entities involved in kickbacks that bilk Medicare funds threaten the program’s fiscal stability and abuse patients’ trust,” said Special Agent in Charge Omar Pérez-Aybar for the Department of Health and Human Services Office of Inspector General (HHS-OIG). “With our partners, HHS-OIG without relent investigates providers that allegedly distort the practice of genetic testing to defraud federal health care programs.”
The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Christopher Improta and Peter Brandt, two marketers who were approached by Ocenture to participate in the alleged kickback scheme. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned U.S. ex rel. Improta, et al. v. Ocenture, et al., Civil Action No. 3:19-cv-358 (M.D. Fla.). As part of today’s resolution, Messrs. Improta and Brandt will receive approximately $570,000.
The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Middle District of Florida, with assistance from the HHS-OIG and the FBI.
The investigation and resolution of this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
The matter was handled by Senior Trial Counsel Laurie A. Oberembt and Assistant U.S. Attorney Ronnie S. Carter.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
https://www.justice.gov/opa/pr/ocenture-llc-and-carelumina-llc-settle-allegations-false-claims-unnecessary-genetic-testing
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