January 10, 2023. At the end of last year, the United States Department of Justice settled a case against a Florida-based genetic testing company and its subsidiary for false claims submitted to Medicare under an alleged kickback scheme. Under the terms of the settlement, Ocenture LLC and Carelumina LLC (collectively Ocenture) paid $3 million. The whistleblowers worked for the marketing company that Ocenture hired to recruit Medicare beneficiaries. Whistleblowers who report fraud against government programs in legal actions called qui tam lawsuits are entitled to a reward in the form of a percentage of the government’s recovery, usually between 15-25 percent. The two whistleblowers in this case were rewarded approximately $570,000 or about 19% of the government’s settlement.
According to the allegations, Ocenture formulated a kickback scheme where, directly and with the help of third-party marketers, they recruited Medicare beneficiaries to participate in genetic testing. Because the genetic testing company submitted claims to Medicare from patients which they paid to recruit, their scheme ran afoul of the Anti-Kickback Statute, which “prohibits paying or receiving remuneration for referring services paid for by federal health care programs,” said the Principal Deputy Assistant Attorney General.
The Anti-Kickback Statute is a federal criminal statute intended to keep third parties from influencing medical decisionmakers who see Medicare and Medicaid patients. In a recent criminal case involving a genetic testing lab attempting a similar kickback scheme, three owners and operators of a genetic testing laboratory were charged with conspiracy to defraud the United States to pay and receive kickbacks and bribes. Convictions carry jail sentences. The False Claims Act is a civil statute that empowers whistleblowers to hold fraudsters accountable for their schemes to “bilk Medicare funds [and] threaten the program’s fiscal stability and abuse patients’ trust,” as the Special Agent in Charge for the Department of Health and Human Services Office of Inspector General for the Ocenture case commented.
The Department of Justice needs whistleblowers who see kickback schemes and say something. Under the False Claims Act, whistleblowers are protected from job-related retaliation for speaking up.
If you would like to report Medicare fraud, you can contact attorneys at Tycko & Zavareei LLP. Eva Gunasekera and Renée Brooker are former officials of the United States Department of Justice and prosecuted whistleblower cases under the False Claims Act. Eva was the Senior Counsel for Health Care Fraud. Renée served as Assistant Director at the United States Department of Justice, the office that supervises False Claims Act cases in all 94 United States District Courts. Eva and Renée now represent whistleblowers. For a free consultation, you can contact Eva Gunasekera at [email protected] or contact Renée at [email protected] (tel.: 202-417-3664). Visit Tycko & Zavareei LLP’s website for whistleblowers to learn more at https://www.fraudfighters.net/.