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Genexe Health Denies Wrongdoing Despite $26,000 Bill To Medicare

FOUNTAIN, Colo. (CBS4) - The Colorado company accused of running a Medicare fraud scheme is defending itself. Last month, a CBS News investigation found Genexe Health was taking advantage of the popularity of genetic tests and potentially costing taxpayers hundreds of millions of dollars. David Palladino, who is Genexe Health's general counsel, tells CBS4 Genexe Health is a "mere marketing service provider to laboratories" -- with no responsibility or involvement in certain testing or billing.

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"Genexe is a marketing services company that no longer furnishes services to clinical laboratories. While we still operated in that industry, we did so with the highest standards of compliance and within the parameters that our clients set for us," Palladino said via email Wednesday.

Sandy Baldwin, who lives in Fountain begs to differ with that characterization of the business. Last October, she came across Genexe representatives offering genetic tests to screen for cancer, she said.

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"My brother is dying of cancer and I thought it's a good opportunity to go ahead and test myself because my dad died of cancer, my other brother died of cancer," Balwdin said.

According to Baldwin, the test was a simple cheek swab. She said representatives told her she'd have the results in a matter of weeks.

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"I asked them how much it would be and they said, 'It won't cost you anything,'" said Balwdin. "They would bill my insurance company, which at that time was Medicare."

Months later, Baldwin recalls she got a report -- but not the results of the cancer screen. Yet she got billing statements for the services charged to Medicare totaling $26,000. Medicare paid about $9,000 of the sum. Baldwin was not responsible for any of it.

"It's you and me and any taxpayer out there," Baldwin said. "And we wonder why the cost of insurance keeps going up and up and up."

An investigation by CBS News found Genexe Health is part of an explosion of marketing companies hiring local recruiters to go where seniors hang out. The cancer test may be the hook but the real goal is to collect as many Medicare numbers as possible.

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Last week, CBS4 went to the company's Greenwood Village office for answers and found a different business' name on the door.

On Wednesday, Palladino, Genexe's attorney, responded to questions from CBS4 via email. He maintained Genexe has never conducted or offered to conduct a genetic test or billed Medicare for any such test

"Genexe was retained to perform very limited marketing services on an arms-length basis by CLIA certified laboratories.  Such laboratories are accredited to submit and receive Medicare payments.  Genexe played no part in such processes and any representations to the contrary are wholly inaccurate.  As a marketer, Genexe has no knowledge of, or access to, any such confidential financial (billing) and/or HIPAA-protected testing results reports (PHI) related information," Palladino said in the email response.

Baldwin has filed a formal complaint about this situation with the Better Business Bureau.

The BBB is now warning anyone to be extra cautious if you come across a company that directly solicits genetic testing.

"Better Business Bureau serving Greater Denver and Central Colorado is warning consumers to exercise caution when doing business with companies that offer genetic cancer screenings and other DNA testing through direct solicitation. Further, BBB has reason to believe that Genexe Health—a company headquartered in Denver Tech Center—was until recently involved in this industry, marketing DNA testing by mouth swab at senior expos and other events," an October 4th press release read.

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