Quest Diagnostics, Inc., based in Secaucus, New Jersey, has paid $13,014,576 plus interest to settle allegations that it submitted false claims to Medicare and the New York and New Jersey Medicaid programs. The U.S. Attorney's Office for the District of New Jersey says the settlement resolves claims that Quest gave doctors, health care executives and other decisionmakers free and exclusive entertainment to win lab referrals, then billed federal health programs for the tests.

The office says the conduct ran from July 25, 2013, to August 3, 2022. Under the Anti-Kickback Statute, prosecutors explain, it is illegal to offer, pay, solicit or receive anything of value to induce referrals for items or services covered by Medicare, Medicaid or other federally funded health programs. The law is meant to keep financial incentives out of medical judgment.

The perks trace back to a deal with a football team. In 2013, the office says, Quest entered a Naming Rights and Sponsorship Agreement with the New York Giants. As part of that deal, the Giants gave Quest suites at MetLife Stadium for home games, along with marketing, commercial programming and hospitality benefits. As alleged, Quest then offered seats in those suites, free of charge, to decisionmakers at its client accounts who could refer patients for lab testing or arrange or recommend referrals.

The office describes what a game day looked like. Guests sat in Quest's suites to watch Giants home games, where Quest also provided food, alcohol and other drinks. In some cases, prosecutors say, guests got parking or field access to watch pre-game warmups. The office says Quest extended these events in certain instances to family members and guests of its clients.

Quest also kept score, according to the office. For the 2013 through 2016 football seasons, prosecutors say, Quest measured its return on investment from the free Giants events. It calculated the revenue it received from a client account for up to one year after entertaining that client's decisionmakers, and compared it to the revenue from the account before the event. Quest then billed Medicare and the New York and New Jersey Medicaid programs for lab tests referred by the client accounts it had entertained, the office says.

Along with the civil settlement, Quest entered a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General. The office says that agreement requires an independent review organization to evaluate Quest's risk assessments and its audits of what it gives to referral sources. HHS-OIG took part in the investigation, and the office says tips about potential fraud can be reported to HHS at 800-HHS-TIPS.