Silicon Valley-based Natera, Inc. agreed to pay over $11 million to resolve claims it improperly billed government healthcare programs for its non-invasive prenatal tests and screenings in violation of the False Claims Act. In resolution of the allegations, Natera will pay over $10.6 million to the federal government and $756,183 to a number of state Medicaid programs.
The suit was initiated by a pair of whistleblowers under the qui tam provisions of the False Claims Act. Former Natera employee Sallie McAdoo and her husband Steven Aldridge filed the suit in January 2015. Following an investigation, the government alleged Natera knowingly submitted false claims to Medicaid, TRICARE, and the Federal Employees Health Benefits programs.
According to the government, Natera improperly billed government healthcare programs for genetic screenings to test a baby’s risk for certain disorders and syndromes. The government claimed Natera billed for the tests despite knowing they were not covered, used an improper billing code to misrepresent the services, and screened patients with low-risk pregnancies.
In a statement issued last week announcing the settlement, United States Attorney Russell Coleman said “let this hefty settlement send a message that pursuing healthcare fraud is a priority of our Office and of the Department of Justice. Overbilling federal healthcare programs steals from taxpayers and drives up the cost of healthcare for us all.”
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