Admera Health, Kickback Scheme, New Jersey 2021

Admera Health LLC, a New Jersey-based company, has agreed to pay the United States $5,389,648 to resolve allegations that it violated the False Claims Act by paying commissions to third-party independent contractor marketers in violation of the Anti-Kickback Statute (AKS).

The settlement, which also includes an additional $147,851 to individual states for claims paid to Admera by state Medicaid programs, resolves allegations that Admera made commission-based payments to independent contractor marketers in return for recommending or arranging for the ordering of genetic testing services from September 1, 2014, through May 21, 2021.

According to the allegations, Admera made millions of dollars of commission payments to independent-contractor marketers to induce them to arrange for or recommend that healthcare providers order and refer clinical laboratory services to Admera.

The allegations state that Admera was informed that the payment of commissions to independent contractors did not comply with the AKS but continued to enter into such contracts.

The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by relators, Sunil Wadhwa and Ken Newton, co-founders of Financial Halo LLC/MedXPrime, a former third-party marketer for Admera.

Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned U.S. ex rel. Wadhwa and Newton v. Admera Health, LLC et al (E.D. Cal.). Relators will receive $862,343 of the proceeds from the settlement.

“The law prohibits health care providers, including those that provide laboratory services, from paying kickbacks in the form of commissions to third parties as an inducement to generate business,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Civil Division.

“By entering into kickback arrangements, health care companies can cause providers to make medical decisions that are motivated by financial gain rather than the patient’s best interest,” said U.S. Attorney Phillip A. Talbert for the Eastern District of California.

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