SNF operator to pay $1 million to settle genetic testing fraud allegations
Prestige has also agreed to cooperate in the ongoing investigation into the scheme, the DOJ said.
A Louisville, KY-based skilled nursing facility operator has agreed to pay nearly $1 million to clear up claims related to its role in a genetic testing scheme that violated the False Claims Act, the Department of Justice announced Monday.
Prestige Administrative Services, doing business as Prestige Healthcare, allegedly partnered with a company called Genomix LLC, which told the provider it could conduct genetic tests on Medicare residents to determine whether they were “properly metabolizing” medication, authorities said in a press release.
Prestige gave Genomix insurance and medical information for, and access to, residents in nursing homes in several states to conduct the testing, but failed to obtain physician orders for the testing or check in with Prestige physicians about the tests' medical necessity. The provider also allegedly failed to inform patients and their families about the testing, and offer them a chance to decline, according to authorities.
The failure to obtain physician orders and resident permission for the tests were uncovered by Wisconsin state surveyors in 2015, the DOJ said.
McKnight's request for comment from Prestige was not returned by production deadline Tuesday.
“As genetic testing technology is evolving, we see the same types of clinical testing abuses that are evident in more established testing,” said Lamont Pugh III, a special agent in charge for the Department of Health and Human Services' Office of Inspector General.
The settlement only resolves Prestige's civil liability, the DOJ said. The provider has agreed to cooperate in an ongoing investigation as part of its settlement.