Potential Medicare Genetic Testing Scam

March 21, 2019

You may have heard about a Medicare genetic testing scam where the test is being offered as part of a free health screening. This could be offered as cancer screening or pharmacogenomic testing. Be aware of this, as the genetic test screening may be an attempt to commit Medicare fraud and/or identity theft.

The test, which is offered as a cheek swab, may be offered at a health fair, seminar, community center, senior housing center, etc.   A representative may falsely indicate that Medicare will pay for the test. This may be an attempt to obtain a Member’s ID and Medicare information. This information could potentially be used to commit Medicare fraud by billing Medicare for thousands of dollars of unnecessary tests or for services that were never received.

Keep these key points in mind should you or your client be approached about this free health screening, which includes genetic testing:

• Genetic tests MUST be ordered by your doctor.
• The genetic test must be medically necessary.
• Contact your plan or Medicare to inquire about coverage before consenting to the test.
• Don’t give your Medicare card, Medicare Number, Social Security card or Social Security Number to anyone except your doctor or people you know should have it.

If an organization approaches you, as an agent, and offers a commission for referrals to do the genetic testing, be aware this is illegal and you could face disciplinary action for participating in this. Keep in mind, it is illegal to accept anything of value in exchange for medical services.

Reporting Medicare Fraud and/or Identity Theft

• If you suspect identity theft, or feel like you gave your personal information to someone you shouldn’t have, contact the Federal Trade Commission at https://www.consumer.ftc.gov/features/feature-0014-identity-theft

• You can contact Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

• You can call the Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8744) TTY users can call 1-800-377-4950.

• You can also report fraud online to the Office of the Inspector General at https://forms.oig.hhs.gov/hotlineoperations/report-fraud-form.aspx

As always, we thank you for your support and cooperation. For questions or comments, please email us at Compliance@NSGACommunications.com or you may call the toll-free number listed below.

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