NEXT Molecular Analytics: Consulting Fees for Test Orders

In the NEXT Molecular Analytics settlement, the laboratory agreed to pay at least $758,000 to resolve allegations that it paid doctors and marketers kickbacks for laboratory-test referrals, then billed Medicare, Medicaid and TRICARE despite knowing about those payments. Consulting fees, medical director fees and sales commissions were the alleged routes to the same destination: more orders for NEXT tests. For someone inside a laboratory or physician’s office, the important connection is between the work a payment supposedly bought and the testing business that followed it.

NEXT Molecular Analytics is the trade name of NEXT Bio-Research Services LLC, a clinical laboratory in Chester, Virginia. The Department of Justice announced the settlement on December 4, 2025. The government described payments to the physicians who could order tests and to independent marketers who could bring those physicians to the laboratory.

Do Doctors Get Kickbacks for Ordering Tests?

Doctors can receive kickbacks disguised as payment for other work. In NEXT’s case, the government alleged that doctors in Texas and Arkansas received thousands of dollars labeled as consulting fees and medical director fees, but offered to induce orders for NEXT laboratory tests.

The fees carried job titles. The government alleged they bought test orders. The question behind the NEXT allegations is what the company was actually paying the physician to do.

That distinction matters to someone who sees the agreement, approves an invoice or works with the physician. The contract describes the promised work. The work performed and the orders sent to the laboratory tell the rest of the story. Our whistleblower experts connect those accounts with the payments and claims.

The purpose of the Anti-Kickback Statute, as the Justice Department explains in its announcement, is to keep improper financial incentives from compromising medical judgment. A doctor choosing where to send a patient’s specimen is making a decision about care. Under the government’s allegations, NEXT put a private payment into that decision while taxpayers received the bill through public health care programs.

Marketer Commissions Tied to Volume and Value

NEXT allegedly paid certain independent-contractor marketers commissions based on the volume and value of referrals. The government said the payments were for arranging and recommending that doctors order NEXT tests. The alleged incentive therefore reached beyond the person signing the order to the person cultivating the account.

A commission schedule connects the marketer’s compensation to the referrals credited to that marketer. Reading it alongside the account’s testing and reimbursement records makes the payment relationship visible.

A separate complaint involving Pacific Toxicology Laboratories shows how explicitly a laboratory commission can follow reimbursement. The whistleblower alleged:

That complaint connects compensation to money received from particular physicians’ referrals. The Justice Department’s announcement describes commissions tied to referral volume and value. For a marketer who knows the accounts, the payment formula can explain why one ordering relationship mattered so much to the business.

The Physician Orders, the Laboratory Bills

A referral-payment arrangement connects the clinician’s decision to order a test with the laboratory’s income from performing it.

Under Medicare’s diagnostic-test documentation rules, the ordering clinician maintains the medical-necessity documentation in the patient’s record. The billing laboratory keeps what the clinician sent and records showing that its claim matches that information. That separation explains why an insider’s view of the ordering relationship can add something that the billing file alone cannot show.

The patient is also removed from the price decision. The Medicare Payment Advisory Commission’s October 2024 explanation of clinical laboratory payment describes no beneficiary cost sharing for services paid under Medicare’s Clinical Laboratory Fee Schedule. The laboratory receives the payment, the clinician orders the service, and the patient has no bill for that covered testing.

For the laboratory, incoming specimens keep equipment and collection networks working. Those fixed costs make volume commercially important. The physician relationship is how that volume reaches the laboratory. A marketer paid according to referrals has a direct financial interest in that relationship.

The clinical and billing records still describe different decisions. The consulting agreement or commission schedule adds the financial relationship behind the order. Putting those records together is how we examine the alleged purchase of testing business.

In NEXT’s case, the government’s allegation joined the payments to the claims: the laboratory allegedly billed the public programs despite knowing about the kickbacks. That is why a healthcare fraud case about laboratory referrals can begin in sales or accounts payable, well before a bill reaches Medicare.

What the NEXT Settlement Requires

NEXT agreed to make additional payments if specified financial contingencies occur, beyond the minimum announced amount. It also agreed to cooperate with the Justice Department’s investigations and cases against other participants in the alleged schemes.

The government had already settled related allegations with NEXT’s National Sales Director and its independent-contractor marketers OC Genetic Consultants Inc. and Ralston Health Group Inc. The laboratory’s settlement addresses its own alleged part in the referral arrangements and billing.

Two whistleblowers brought the False Claims Act case that included the NEXT allegations. The Justice Department said they would receive a share of the settlement proceeds. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

Admera Health’s Separate Settlement

Admera Health reached its own settlement in July 2024 over alleged commission-based payments to independent-contractor marketers. The Justice Department’s Admera announcement concerned the same whistleblowers, co-founders of a former third-party marketer for Admera. The NEXT resolution followed in the same whistleblower case, with NEXT making its own payment.

The distinction puts the marketing side of the business in view. The people who brought the Admera case knew the third-party marketing arrangement. A laboratory employee sees one side of a referral relationship. The marketer who develops the accounts can see another.

The Work Behind the Agreement

The useful business records connect compensation to work and referrals. A laboratory’s written policies may describe one arrangement while its account activity and payment records describe another. People who know how the business operated can explain that difference.

A written description of services tells us what the parties said they were buying. Work records, account activity and payments help us examine what the arrangement delivered. A policy matters because the people administering the arrangement can explain whether the business followed it.

In a separate Genotox Laboratories complaint, a whistleblower alleged that a marketing-services agreement paid a former sales representative who did little beyond keeping an account:

The contrast is concrete: an agreement for services and an allegation that retaining the account was the only work. In a case about fees and referrals, someone who knows what a consultant or representative actually did can supply the connection the contract leaves out.

You Know What the Fee Bought

If you worked with the consulting agreements, physician accounts or marketer payments, speak to our whistleblower experts about what the fees really bought. We connect your knowledge of the business to the laboratory’s government claims and bring in laboratory fraud whistleblower lawyers to build your strongest laboratory kickback whistleblower case. We stay with you through the case.