We represent victims of reverse discrimination and anti-DEI whistleblowers

Breast cancer is a devastating disease and doctors have emphasized the importance of early testing for decades. While mammograms and other diagnostic procedures are often medically sound, there are also instances where certain tests are not beneficial to the patient. One company that specializes in molecular diagnostics recently paid millions of dollars to the government to settle allegations of Medicare and Medicaid fraud stemming from needless tests.

The federal Department of Justice announced that Tennessee-based Agendia, Inc. agreed to pay a minimum of $3.25 million in response to charges that they used various methods to bill the government for unnecessary genomic testing. The crux of the allegations was that Agendia influenced physicians and providers to order MammaPrint tests, leveraging standing or automatic orders to compel authorization for these procedures.  

Compounding these issues were allegations of illegal remuneration, with Agendia purportedly incentivizing referrals through extravagant gifts, honoraria and per-referral payments. Such practices violate anti-kickback statutes, which are designed to protect the integrity of clinical decision-making. In conjunction with Agendia’s settlement, Knoxville Comprehensive Breast Center (KCBC) and Knoxville Dermatopathology Laboratory (KDL) resolved related allegations for $322,500 and $207,500, respectively. 

The civil settlement resolution is significantly attributed to qui tam actions initiated by Dr. Raymond Brig and Mr. Lance Albertson. Under the False Claims Act's whistleblower provisions, these individuals filed lawsuits on the government’s behalf. In recognition of their contribution, Dr. Brig and Mr. Albertson stand to receive $296,725 from the settlement proceeds, which could increase to $921,725, reinforcing the financial and ethical incentives for exposing fraudulent schemes to obtain government funds. 

Unfortunately, the medical industry is rife with examples of companies and individuals trying to take advantage of an overburdened public health insurance system. Claims for unnecessary procedures and improper inducements to doctors are not uncommon, but they are hard to detect from the outside. That’s why whistleblowers are so important in the rooting out of Medicare and Medicaid fraud, and why they can be rewarded so well if the government collects a major amount as is in the Agendia case. 

Kardell Law Group has a long track record of successfully asserting the rights of whistleblowers. We can review the facts in your case and explain how the federal False Claims Act authorizes payments to individuals who come forth with credible evidence that someone is cheating the government.