Tuesday, September 20, 2022

Genomeweb Highlights $94M Genetics Fraud Case; See My Very Recent Blog & Video

In an open access article, Genomeweb highlights a new guilty plea in a $94M genetic testing scheme case. A Ft. Lauderdale lab is highlighted.   How many Ft. Lauderdale genetics labs were there?  One.  Are its billing records public at CMS.gov?  Yes.  

The Ft Lauderdale lab was billing FCSO MAC huge amounts of claims and 90%  for Tier 2 codes, mostly code 81408 (full sequencing of very rare genes and in multiples per each Medicare patient.)   

My video is a little caustic and I go through some CMS remarks where you really have to turn on your "B.S." detector and if you do, it will emit a piercing squeal.  

This was abuse you could train a ten year old to recognize in 3 minutes, yet it reached many hundreds of millions of dollars at this and other labs with near-identical patterns - and only in 1 or 2 MACs out of the whole US.  And year after year (2018, 2019, 2020...).


https://www.360dx.com/clinical-lab-management/florida-man-pleads-guilty-cancer-genomic-testing-schemes-pay-974m#.Yyo10XbMKM8


Earlier this month, I highlighted this DOJ indictment in a blog and a short 3 minute video.

Blog:

http://www.discoveriesinhealthpolicy.com/2022/09/brief-blog-genomeweb-fraud-article.html

Video:

https://www.youtube.com/watch?v=WH_Eb0_X9q8


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The new Genomeweb article cites "a man from Ft Lauderdale" but the just-prior DOJ indictment and press release on the same man, refer to "labs in Houston and Ft. Lauderdale."  (See my blog linked just above).  While there were 10 labs in Houston with unrealistic of Tier 2 and 81408 billing, there was only 1 such lab, in Ft. Lauderdale.