A California-based medical testing company has agreed to a multimillion-dollar settlement regarding false Medicare claims allegations that were first made public in a lawsuit filed by the former employee of a local hospital, prosecutors say.
California-based molecular diagnostic testing company Agendia Inc. has agreed to an $8.25 million settlement with the federal government to resolve allegations of a nationwide scheme to bill Medicare for the company’s MammaPrint genetic test, the Justice Department announced Wednesday.
Agendia was accused of conspiring with hospitals across the country to artificially delay ordering MammaPrint genetic assay procedures to get around Medicare’s 14-day rule. That rule is meant to prevent medial laboratories from billing Medicare separately for tests or specimens if a doctor ordered them within 14 days of when a patient was released from a hospital. If a test is performed after that 14-day period, the rule allows laboratories to bill Medicare directly for the test.