Medicare Genetic Testing Fraud Case Settled for $6M Over False Claims

Genexe, LLC, Immerge, Inc., and their executives Jason Green and Jason Gross have agreed to pay $6 million to resolve allegations of submitting false Medicare claims for medically unnecessary genetic tests involving cancer screening (CGx) and pharmacogenomic profiling (PGx).

These genetic tests, which analyze inherited gene mutations to guide disease risk and drug response, were reportedly procured through kickbacks and lacked legitimate medical necessity. Genexe and Immerge, operating from Greenwood Village, Colorado, are no longer in operation following the allegations.

The U.S. government emphasizes that Medicare only covers clinical lab tests ordered by treating physicians related to specific medical issues, and violations of these requirements or laws like the Anti-Kickback Statute can lead to legal actions and substantial recoveries.

The settlement includes whistleblower suits under the False Claims Act, with relators receiving a share of the recovery, highlighting ongoing federal efforts to combat fraud, waste, and abuse in healthcare programs. This case illustrates regulatory vigilance over genetic testing claims and reinforces compliance requirements for Medicare billing in laboratory services.