June 1, 2022
Caris Life Sciences, Inc. will pay
$2.9 million to resolve claims that it falsely billed Medicare for laboratory tests to detect the activity of certain genes within a tumor that predicted the risk of recurrence by fraudulently circumventing Medicare’s 14-day rule, which, during the relevant time period, prohibited laboratories from separately billing Medicare for tests performed on specimens if a physician ordered the test within 14 days of the patient’s discharge from a hospital stay. By submitting separate claims for the laboratory tests, Medicare paid twice for the same service, first to the hospital as part of the hospital’s lump-sum DRG payment, and in a direct payment to Caris. Caris allegedly discouraged providers from ordering testing within 14 days of discharge, or canceled and re-submitted orders to avoid the 14 day window. The settlement covers two separate whistleblower actions.
USAO EDNY
