Texas Health System Fined $431K for Falsely Billing Genetic Tests

Case: The feds contend that between 2016 and 2018, Decatur Hospital Authority (d/b/a Wise Health System) sent samples from surgical patients to Tennessee labs for medically unnecessary genetic tests. Rather than risk a trial, Decatur has agreed to settle the claims for $431,182.

Significance: This case is the most recent example of how prosecutors and whistleblowers have begun applying traditional lab fraud laws, e.g., false billing and kickbacks, to newfangled genetic testing. One of the biggest cases was the 2018 $11.4 million settlement with Natera over alleged false billing of the Panorama sequencing-based prenatal screening test. (For more details, see LCA, March 26, 2018.

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