PROGENITY, INC. Molecular and diagnostic test provider (“PROGENITY”), based in San Diego, reached a $49 million settlement for dishonest billing and kickback practices. In order to get doctors to order PROGENITY tests for their patients, the biotechnology company allegedly gave them kickbacks and submitted false claims for prenatal tests to federal healthcare programs. By using a billing code that falsely represented the tests being provided, PROGENITY allegedly overbilled Medicaid and the VA. Additionally, the company allegedly gave physicians illegal kickbacks in the form of meals, happy hours, and the improper reduction or waiver of patient co-insurance and deductible payments.
Acting U. S. “Progenity received millions of dollars from federal healthcare programs through its false billing and kickback schemes,” said attorney Audrey Strauss. By paying doctors exorbitant fees and providing meals and happy hours for them and their staff, the company attempted to persuade doctors to order Progenity tests while falsely representing the tests it conducted. In the event that healthcare providers commit fraud or other unlawful acts, our Office will continue to hold them accountable. ”.
To resolve claims of kickbacks and fraudulent billing, PROGENITY will pay the United States $19,449,316 under the settlement agreement approved on July 23, 2020. Additionally, the business has agreed to settle these claims by giving states a total of $13,150,684 In addition, PROGENITY has agreed to pay $16. 4 million in a separate civil settlement to resolve comparable fraudulent billing claims relating to TRICARE and the Federal Employees Health Benefits Program.
In connection with this agreement, the Government joined a private False Claims Act lawsuit brought by a whistleblower who claimed that PROGENITY engaged in wrongful kickback schemes.
HHS-OIG Special Agent in Charge Scott J. Kickbacks and fraudulent billing practices compromise patient care, undermine the integrity of our healthcare system, and place an increased financial burden on taxpayers, according to Lampert. HHS-OIG will continue to make sure that those billing federal health insurance programs do so honestly, working with our law enforcement partners. ”.
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Is Progenity covered by insurance?
Cell-free DNA analysis-based non-invasive prenatal testing is not regarded as diagnostic. Once you have your Progenity Inc. Depending on the results of the test, you can talk to your doctor about your prenatal care. Progenity Inc. is covered by many insurance plans.
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What does PROGENITY do?
About Progenity Progenity develops a range of investigational ingestible devices that are intended to deliver precise diagnostic sampling and drug delivery solutions using a multi-omics approach that combines genomics, epigenomics, proteomics, and metabolomics.
Where is Progenity located?
Where is Progenity’s corporate office? Progenity’s corporate office is located at 4330 La Jolla Village Drive in San Diego.
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