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Genetic testing settlement: KY Medicaid program to get $41K

To date, efforts by AG Andy Beshear's office through civil settlements and criminal restitution resulted in over $71 million in obligations to the state and federal Medicaid program, Medicare, Tricare, commercial payers and other entities.
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By Terry Sebastian or Crystal Staley
News from Kentucky Attorney General Andy Beshear's Office

FRANKFORT, KY (Fri 27 Apr 2018) - Attorney General Andy Beshear today announced a settlement of more than $41,000 as part of a Medicaid fraud case involving genetic testing services.

The settlement resolves allegations that Delaware-based Natera submitted false or fraudulent claims to government health care programs for its preconception and prenatal genetic testing services.

Specially, the states alleged that Natera improperly billed for tests that were not subject to reimbursement, caused misrepresentations of the services and thus falsely obtained payments, and caused reimbursements of tests at a higher rate than otherwise allowed.

As part of the agreement, Kentucky's share of the settlement is $41,100 for the state and federal shares of restitution to the Medicaid program and other recovery. Kentucky's amount from the settlement is based on the usage of the genetic testing services by doctors in the state.

The multistate attorneys general investigation stemmed from a civil case - United States ex rel. Sallie McAdoo and Steven Aldridge v. Natera Inc., (No. 3:15-cv-88-DJH) - pending in the United States District Court for the Western District of Kentucky.

This civil action against Natera alleges claims under the federal False Claims Act and various state false claims statutes by individual citizens.

A National Association of Medicaid Fraud Control Units Team participated in the settlement negotiations with Natera on behalf of the states.

Beshear's executive director of his Office of Medicaid Fraud and Abuse served as a member of the settlement team, along with representatives from AG offices in Indiana, New Mexico, New York, and Ohio.

The United States Attorney's Office, Western District of Kentucky litigated the case. The Department of Defense, Office of Inspector General, Defense Criminal Investigative Services (DCIS) and the Defense Health Agency (DHA) investigated the case.

Beshear has made protecting Kentucky families one of his office's top priorities.

Upon taking office, one of the first steps Beshear took was to expand Kentucky's Elder Abuse Hotline to 24/7 to help ensure seniors are protected both day and night.

To report any instances of patient abuse or Medicaid fraud to the Attorney General's Elder Abuse Hotline call, 877-ABUSE TIP.

To date, efforts by Beshear's office through civil settlements and criminal restitution resulted in over $71 million in obligations to the state and federal Medicaid program, Medicare, Tricare, commercial payers and other entities.

This story was posted on 2018-04-29 09:04:23
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