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Whistleblower Law Collaborative attorney Bob Thomas recently discussed genetic testing fraud for Stat News. Bob wrote that genetic testing costs as much as $10,000. Due to the significant profit potential, “opportunists see an opening.”
Also, HHS-OIG issued a Fraud Alert about genetic testing fraud.
“Scammers are offering Medicare beneficiaries cheek swabs for genetic testing to obtain their Medicare information . . . Fraudsters are targeting beneficiaries through telemarketing calls, booths at public events, health fairs, and door-to-door visits… If a beneficiary agrees to genetic testing or verifies personal or Medicare information, a testing kit is sent even if it is not ordered by a physician or medically necessary.”
Bob explained how genetics fraud works.
What’s going on here is the same pattern of activity that has occurred throughout the health care system: a great majority of law-abiding actors and a few that seek out opportunities to game the system of government reimbursement. If you can get a saliva swab and a Medicare number from an unsuspecting senior and falsify a doctor’s order (or find a shady doctor to write one), there’s an easy four-figure sum to be had. And if you’re willing to repeat that dodge a few hundred or a few thousand times — you get the idea.
Medicare is facing a wave of genetic testing fraud. And the government is intent on ending it. If you know about genetic testing fraud, please Contact Us.