July 1st, 2019
The Office of Inspector General for the United States Department of Health and Human Services has issued a fraud alert about genetic testing scams, in which companies send patients a free genetic testing kit as a way of stealing their identity information, which is then used to bill fraudulent services. This is a new twist on two tried-and-true scams. The first scam involves fraudulent claims for durable medical equipment, such as wheelchairs and expensive braces. You may have been getting calls from fraudulent telemarketers telling you that your insurance company has approved you for an expensive brace for your back or you knee. Often, such calls were a way for the fraudsters to steal your medical information and use it to bill for fraudulent services. The Department of Justice recently cracked down on that scam, filing criminal charges against 24 individuals who allegedly stole more than $1.2 billion.
Next, some clinical laboratories have been fraudulently billing for expensive genetic tests that were not related to a patient’s actual diagnoses, were not proven to be effective in helping treat a patient’s diagnosis, or repeatedly performing a genetic test for no good reason.
The new fraud alert warns about a fraud scheme that combines the two – using stolen patient information to order expensive genetic tests, and even to submit claims to Medicare and other insurers for services that were never actually performed. Reportedly, scammers offer Medicare beneficiaries cheek swabs, ostensibly to provide a battery of genetic testing, turn around and sell identity information to those who seek to defraud these unsuspecting individuals and their insurers.
If you or a family member is offered a “free” genetic test, especially if the offer comes from a telemarketer, a booth at public events, or door-to-door visits, be wary. Check with your doctor, and only give someone your personal and medical information – especially samples of your DNA – if you have confirmed with your doctor that it is to be used for a legitimate and medically necessary test.
Caution is essential not only to protect your own identity, but also to prevent the government from footing the bill for fraudulent tests. We all pay the price when the government is defrauded – your vigilance can be the first step to fighting back.
If you think that company you have worked with or has provided services to you might be engaging in this type of fraud, please feel free to reach out to me with questions at The Whistleblower.com.