Fortresses, which are easiest to storm from within
—Foreword
How much does it cost for an alliance of interests built up with millions of dollars to be "divided"?
The answer is 800,000
- enough for them to backstab their buddies.
Today's anti-corruption story is very interesting, not only the punishment clause is extremely brutal, but the psychological game in the process is also very exciting.
It's a good show, it's over.
Admera, known in China as Suzhou Admera, is a genetic testing company spun off from Genewiz.
In 2014, when Admera was born, the clinical genetic testing market in United States was no longer a blue ocean
- Taking oncology as an example, FMI was established as early as 2010, and Guardant Health is 2 years old.
How does a newcomer snatch food from the mouth of his seniors?
Admera thought about it for a long time and found a solution that she thought was "brilliant".
The first step is to find some independent marketers – commonly known as "lobbyists".
The second step is to have them go on an academic visit and persuade doctors to choose the company's genetic testing products.
The third and most important step is to offer high rebates.
From the first year of its existence, Admera gave the condition of "no refusal":
"For each test referred, 33%-50% of the reimbursement amount or a fixed fee will be awarded"
Although they are all packaged as "marketing spend", these expenses are very clear "rebates":
"The final amount is only closely related to the number of genetic tests and the cost of medical insurance reimbursement"
In just a few years, the rebate amount reached millions of dollars.
Human nature is very mysterious, and when the money is in place, many things will naturally be in place.
"If you are generous, I will live up to it"
Admera's sales have grown rapidly, and in 2016 it was awarded a "North American Technology Innovation Award" by Frost & Sullivan (yes, Frost ·& Sullivan, the most commonly cited "painting cake" label in China).
Impressive, really Impressive
But the wool of medical insurance can you pick up casually?
美国的《反回扣法》(Anti-Kickback Status, 42 U.S.C. § 1320a-7b)明文规定：
Any person is prohibited from offering, paying, soliciting or receiving any form of kickback, remuneration or other compensation for the purpose of obtaining business, purchase orders, recommending or arranging payment for any medical service or item, especially for medical reimbursement items.
Admera knows the forbidden area of the law, but it wants to gamble:
Under the interests of millions of dollars, the offensive and defensive alliance is so indestructible - God knows, the earth knows, you know, I know, God doesn't give face when he comes.
What's more,
"Since ancient times, wealth and wealth have been sought in danger"
Many years ago, the Austrian author Stefan · Zweig wrote such a sentence in "The Guillotine Queen".
"All the gifts of fate have been secretly priced"
And this time, the price is "betrayal".
Sunil Wadhwa和Ken Newton,是Admera的金牌合作伙伴,他们创立的Financial Halo LLC/MedXPrime这几年靠回扣赚的盆满钵满。
On July 11, 2019, the former "comrade-in-arms" showed a dagger with his backhand.
"Report Ah sir, I report, this company is illegal!"
At this level of internal and external cooperation, Admera was investigated with almost no resistance.
In November 2020, CMS was the first to suspend Medicare reimbursement for Admera
- A very precise slash on the main artery.
Without a big funder, Admera was unable to support it, and announced in September 2021 that it was seeking to divest its clinical testing business and transform it into an R&D services company.
On July 24, 2024, HHS-OIG (Office of the Attorney General of the United States Department of Health and Human Services) announced a "civil settlement" with Amera
——The six articles are extremely brutal, enough to "set an example for a hundred"
- Fixed Compensation Amount:
$5,537,500, which must be paid.
- Floating amount A: Don't make it too big in the future
3.5% of the protection fee is payable for the amount exceeding the "income limit"; (The cap for 2024 is $19.8 million)
- Floating Amount B: Want to Sell Assets?
I'm sorry, but 50% of the proceeds from the sale of assets must be paid as a protection fee;
- Floating amount C: I heard that you don't do clinical testing?
If someone takes over this part of the asset, you also have to pay a protection fee
- 50% if it does not exceed $8.6 million; Over $8.6 million, $4.3 million + 67% of the excess.
- Floating Amount D: Heard you have a $3.34 million pending lawsuit?
If the amount of the sentence changed on appeal is less than this figure, 25% of the difference will be used to pay protection money.
With so many overlord clauses, is it good for Admera to file for bankruptcy?
Not good.
If the property is transferred through bankruptcy liquidation to "evade" compensation, the settlement will immediately lapse and United States' claim against Admera will suddenly rise to $57,978,800.
"I can't survive, I can't die"
It seems that it is another happy ending of "bad people are punished".
But the real exciting game is hidden outside the story.
Why are brothers suddenly turning against each other?
The last time Guardant Health was not discovered because of conscience, and this time the two whistleblowers obviously will not "kill their relatives in righteousness".
Everything, we have to return to the word "interests".
A strong alliance of interests, with what everyone knows as the Achilles heel: the greater good.
"When you stare into the abyss, the abyss stares at you"
And the law has already buried the bait to lure the fish to the bait.
Under Section 3730(d) of Title 31 of the United States Code, a citizen may bring a lawsuit "on behalf of" the government for violations of the Anti-Kickback Act, and:
"The whistleblower can get a 15%-25% share of the final compensation"
The whistleblowers, Sunil Wadhwa and Ken Newton, received the following benefits:
"16%, with a minimum guarantee of $862,300 and an expected return of more than one million"
In "Let the Bullets Fly", Master Tang played by Ge You homonyms the dollar into a "knife".
"The dollar is like a knife, and the knife edge is inward"
Report first, be exempted first, and take the money, and be reported to pay a fine and eat jail.
When the law orchestrates the prisoner's dilemma for them, the brothers are just a fish destined to be baited.
"You are all part of the legal play"
Back in July 2019
"Give me a chance, I want to be a good person"
"I'm sorry, they gave too much"
Source: Funny fat man is one in a million