On July 24, the Department of Justice announced that Admera Helath LLC, a New Jersey-based company that provides genomic and bioinformatic services to researchers and clinical laboratory testing services to healthcare providers, has agreed to pay $5,389,648 to settle allegations that it violated the False Claims Act by paying commissions to third party independent marketers in violation of the Anti-Kickback Statute.
The settlement resolves a qui tam whistleblower lawsuit filed by relators Sunil Wadhwa and Ken Newton, who are the co-founders of Financial Halo LLC/MedXPrime, previously a third-party marketer for Admera. The whistleblowers will receive $862,343 of the total share from the settlement.
The False Claims Act’s qui tam provisions enable private citizens and private parties to file lawsuits on behalf of the government if they know of an individual or company defrauding the government. Qui tam whistleblowers can receive between 15 and 30% of the government’s recovery.
The government alleges that from September 1, 2014, through May 21, 202, Admera provided commission-based compensation to independent contractor marketers “in return for recommending or arranging for the ordering of genetic testing services,” which is a violation of the Anti-Kickback statute (AKS).
According to the government, “Admera has admitted that it made millions of dollars of commission payments to independent-contractor marketers (the Marketers) to induce them to arrange for or recommend that healthcare providers order and refer clinical laboratory services to Admera, including genetic tests, that were reimbursable by Medicare and/or Medicaid, that it paid Marketers through arrangements that took into account the volume and value of genetic testing referrals, and that Admera was informed that the payment of commissions to independent contractors did not comply with the AKS but continued to enter into such contracts.”
“The law prohibits health care providers, including those that provide laboratory services, from paying kickbacks in the form of commissions to third parties as an inducement to generate business,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department is committed to holding accountable those who engage in kickback arrangements that undermine the integrity of federal healthcare programs.”
In July 2023, a bipartisan group of senators introduced the False Claims Amendments Act of 2023, which address a few technical loopholes undermining the success of the FCA. The bill is widely supported by whistleblower advocates.
National Whistleblower Center (NWC) has issued an Action Alert calling on Congress to pass the bill.
Join NWC in Taking Action:
Demand that Congress strengthen the False Claims Act
Further Reading:
Bipartisan Legislation Unveiled to Strengthen False Claims Act