Was there an Oncotype case based on surgeon test orders? I can't find one.

 Beginning in around 2008, Medicare covered the Oncotype Dx test, a breast cancer molecular prognostic test used for decisions about cancer management after an initial resection (lumpectomy). I believe (based on a vague memory) there was a legal case or whistleblower case at one point that the company, genomic health, was processing orders for the test coming from surgeons rather than the "treating physician," that is, an oncologist. However, I'm not able to find this on Google. 

 I *am* able to find a recent case where Genomic Health and its parent company Exact Sciences were fined for suggesting that hospitals order tests after 14 days, to avoid bundling under the medicare 14-day rule. However, I'm looking for a case or news article where the misbehavior was considered to be surgeon-based or pathologist-based orders of the Oncotype Dx test. Do you know of anything?

ChatGPT said:

I understand you're seeking information about a legal or whistleblower case involving Genomic Health's Oncotype DX test, specifically concerning orders placed by surgeons or pathologists instead of oncologists. While I couldn't locate a case precisely matching that description, there is a related settlement that might be of interest.

In October 2023, Genomic Health, Inc. (GHI), a subsidiary of Exact Sciences Corporation, agreed to pay $32.5 million to resolve allegations of violating the False Claims Act. The allegations centered on GHI's manipulation of Medicare's 14-Day Rule, which dictates billing procedures for certain laboratory tests. The U.S. Department of Justice contended that GHI improperly billed Medicare for Oncotype DX tests ordered within 14 days of a patient's hospital discharge, a period during which such tests should have been included in the hospital's lump-sum payment. Additionally, GHI was accused of encouraging hospitals and physicians to cancel and reorder tests to bypass the 14-day window, thereby enabling direct billing to Medicare.

justice.gov

While this case primarily addresses the circumvention of billing rules related to the timing of test orders, it does not specifically mention issues related to orders being placed by surgeons or pathologists instead of oncologists. If you have more specific details or context, I can assist further in searching for information that closely matches your inquiry.

You said:

Beginning in around 2008, Medicare covered the Oncotype Dx test, a breast cancer molecular prognostic test used for decisions about cancer management after an initial resection (lumpectomy). I believe there was a legal case or whistleblower case at one point that the company, genomic health, was processing orders for the test coming from surgeons rather than the "treating physician," that is, an oncologist. However, I'm not able to find this on Google. I *am* able to find a recent case where Genomic Health and its parent company Exact Sciences were fined for suggesting that hospitals order tests after 14 days, to avoid bundling under the medicare 14-day rule. However, I'm looking for a case or news article where the misbehavior was considered to be surgeon-based or pathologist-based orders of the Oncotype Dx test. Do you know of anything?  (ASKED THIS TIME VIA INTERNET BUTTON)

ChatGPT said:

I understand you're seeking information about a legal or whistleblower case involving Genomic Health's Oncotype DX test, specifically concerning orders placed by surgeons or pathologists instead of oncologists. After reviewing available information, I couldn't locate a case precisely matching that description.

The recent settlement involving Genomic Health, Inc. (GHI), where the company agreed to pay $32.5 million to resolve allegations of violating the False Claims Act, primarily addressed issues related to the manipulation of Medicare's 14-Day Rule. The allegations included improper billing practices and encouraging hospitals and physicians to cancel and reorder tests to circumvent billing regulations. However, this case did not specifically mention concerns about tests being ordered by surgeons or pathologists instead of oncologists.

justice.gov

Additionally, a medical malpractice lawsuit was reported where a patient alleged that her physician failed to recommend the Oncotype DX assay, which she claimed could have indicated the need for chemotherapy and potentially prevented cancer recurrence. This case highlights the importance of appropriate test utilization but does not pertain to the specific issue of test ordering by surgeons or pathologists.

pmc.ncbi.nlm.nih.gov

Given the lack of publicly available information on a case specifically involving surgeon- or pathologist-ordered Oncotype DX tests, it's possible that such a case either remains confidential or has not been widely reported. If you have more specific details or additional context, I can assist further in searching for information that closely matches your inquiry.