Genexe and Immerge: A Cheek Swab, a Paid Referral, and a Medicare Bill

The Genexe Immerge fraud case produced a $6 million settlement over allegations of medically unnecessary genetic testing and kickbacks. The government alleged that contractors recruited Medicare beneficiaries at skilled nursing facilities and other locations, collected cheek swabs, and supplied a network of telemedicine providers and laboratories. Laboratories billed Medicare and paid Genexe a share. For someone who worked in screening, ordering or billing, the case connects what happened at the collection table to where the money went afterward.

What Genexe and Immerge Were Alleged to Do

Genexe marketed genetic testing as Genexe Health, and Immerge was its controlling parent. Both companies were based in Greenwood Village, Colorado, and had stopped operating by the settlement announcement. The settlement also covered their chief executive and chief operating officers, who owned interests in both businesses.

According to the Justice Department, Genexe advertised itself as “a one-stop shop” covering patient screening, sample collection and laboratory processing.

The Justice Department’s allegations covered July 2018 through December 2019. It said Genexe contracted with telemedicine providers and medical laboratories to expand genetic-testing services nationwide, then hired independent contractors to recruit patients. Most of the contractors had no medical training, according to the government’s account. They acted as genetic screening technicians and offered testing purportedly at no cost to patients.

The tests concerned hereditary cancer risk and how a patient’s genes affect responses to medications, commonly called CGx and PGx tests. The government’s allegation was that paid recruitment and paid orders generated testing that patients did not medically need.

From a Cheek Swab to a Medicare Claim

The alleged business depended on moving a specimen through an ordering and billing network. Contractors collected patient information on requisition forms, labeled the swabs and shipped the packaged specimens to Immerge in Colorado. Genexe then obtained physician orders before sending the specimens to a laboratory.

The government’s account of the arrangements describes orders obtained through telemedicine companies or laboratories with physician arrangements. The receiving laboratory could test and bill itself or send the work to another laboratory.

According to the Department of Justice, laboratories regularly received more than $6,000 per test from Medicare. After Medicare paid, the laboratory sent part of the reimbursement to Genexe. Taxpayers were funding the alleged referral business through bills for patient care.

Genexe initially received about $800 per swab, later $1,000 to $2,000 depending on the test. The alleged kickbacks ran through the business: payments for beneficiary referrals, payments for test prescriptions, and payments back to Genexe for sending swabs and orders to laboratories.

The patient’s care was supposed to drive that process. As the release explains, Medicare Part B coverage requires a clinical laboratory test to be ordered by a treating physician or qualified practitioner for a specific medical problem, with the results used to manage that problem. In the alleged Genexe arrangement, the specimen came first and an order followed through the commercial network.

Genetic Testing Recruited at Skilled Nursing Facilities

Skilled nursing facilities were among the locations where Genexe’s contractors allegedly collected cheek swabs and beneficiary information. The government also named stores, shopping malls, healthcare fairs, churches and retirement centers.

Under Medicare’s nursing-home billing rules, laboratory services fall within the facility’s bundled Part A payment unless an exclusion applies. The resident’s coverage matters when tracing a laboratory bill for a swab collected at a nursing home. Our experts connect that coverage with the laboratory claim and the referral payments.

What Is a Red Flag for Health Care Fraud?

A screening script that steers answers toward a test, followed by an authorization after the swab is collected, is a concrete concern in this case. The whistleblower’s complaint describes the process from the perspective of a contracted marketer and genetic screening technician in the St. Louis area.

The whistleblower alleged that marketers were told to wear scrubs or lab coats so they looked like medical professionals. The complaint then described how they were taught to turn an unpromising family history into a reason to test:

The alleged training aimed at an answer that would support a sale. If cancer testing did not work, marketers were told to ask about medications and pitch drug-response testing to people taking three or more.

The complaint identified Gold Rush and Silver Rush as companies that contracted with the whistleblower to market testing. It alleged that they paid St. Louis marketers $100 for each CGx or PGx referral obtained on Genexe Health’s behalf. It also alleged that Genexe initially encouraged gift cards to induce testing, then told marketers to stop during the summer of 2019.

After the questionnaire and swab, the complaint said, the marketer called a telehealth provider and handed the phone to the patient. The provider then supplied an authorization number for the sealed swab’s bag. Patients later complained that their results never arrived, despite customer-service assurances that testing had just been completed. The complaint alleged claims for unnecessary tests, tests never performed or tests whose results were not delivered.

Nursing Home Access Turned Into Laboratory Billing

A separate case involving Provista Health shows another way testing access at nursing homes can lead to unnecessary laboratory claims. The government alleged that access for COVID testing became a route to billing unnecessary respiratory pathogen panels, including tests that were not requested or performed. The court entered default judgments in 2024 after the defendants failed to defend the case.

The shared question is what happened between access to a resident and the test billed to Medicare. A screening event, a specimen, an order and a claim each describe a different part of the transaction.

What Evidence Is Needed to Prove Fraud?

For these allegations, the useful evidence connects the recruiting instructions, the patient information and specimen, the physician order, the laboratory claim and the payments for referrals. The Genexe complaint makes the recruiting side concrete: training, questionnaires, contractor compensation and calls about missing results. The Department of Justice’s account describes the relationships between the marketing company, telemedicine providers and laboratories.

A contractor may know how the family-history answers were obtained. Someone handling requisitions or telemedicine orders may know when an order was added and which provider authorized it. A laboratory billing or finance employee may see the Medicare reimbursement and the payment sent back to the marketer.

Our work brings those accounts together with the contracts and clinical records. We examine how the claimed medical need arose, who controlled the referral and order, and how payment depended on the resulting test. That gives an insider’s account its connection to the government claim.

The Settlement and Whistleblower Reward

The Justice Department announced the settlement in April 2025. It resolved the genetic-testing and kickback allegations against the marketing companies and their two executives, including claims in cases brought by whistleblowers under the False Claims Act.

The Justice Department said four whistleblowers would collectively receive approximately $1.3 million as part of the resolution. One complaint came from the contracted marketer whose account described the screening-table practices.

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Saw How the Test Was Sold

If you handled screening visits, test orders or laboratory payments, speak with our whistleblower experts about what you saw. We build your strongest case around the recruiting, ordering and billing decisions you know and bring in healthcare fraud whistleblower lawyers who understand laboratory kickbacks. We stay beside you throughout the case.