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WARNING: 'Free' genetic testing being used to steal Medicare benefits

Posted at 2:58 PM, Sep 11, 2019
and last updated 2019-09-11 17:58:19-04

The Director of the Nevada Senior Medicare Patrol is warning Nevadans about genetic testing company representatives offering “free” genetic tests to Medicare beneficiaries.

These tests can also be referred to as DNA screenings, cancer screenings or hereditary testing and company representatives go door-to-door or visit senior centers, senior housing, veterans events, health fairs, and other locations where people gather to convince people to let them take a cheek swab for testing.

These fraudulent companies promise that the results will help recipients avoid diseases or find the right medications and all they require is a cheek swab and the person’s Medicare number.

“These companies can steal people’s medical identity and falsely bill Medicare, draining the system of needed funds. Tests ordered under these circumstances are unnecessary and could lead to confusion about someone’s health condition,” said Kim Harney-Moore, Director of the Nevada Senior Medicare Patrol (SMP).

Due to confusion regarding Medicare’s coverage for genetic tests for cancer and other conditions, the Office of Inspector General (OIG) released a fraud alert advising the public to be suspicious of anyone who offers free genetic testing and requests their Medicare number.

Federal regulations state that diagnostic tests must be ordered by the physician who is treating the patient and the IOG warns consumers against signing off on any tests not requested by a known and trusted physician.

“A doctor who has never met or examined a patient, often hired by a genetic testing company, should not be authorizing any tests. That’s a red flag,” said Harney-Moore.

In addition to compromising a consumer’s personal information, agreeing to a test not requested by a physician may leave the patient responsible for the cost of the unauthorized test.

The SMP recommends that beneficiaries should:

· Refuse to give their Medicare number and/or personal information (such as their Social Security number) to any person or business offering screening services, including cheek swabs or blood tests, at community events, local fairs, farmer’s markets, parking lots, and/or similar event

· Decline participation in screening or genetic testing with anyone that is not their own doctor

· Go to their own doctor to assess their condition or needed screenings, not a doctor on the phone they’ve never met from a company they don’t know

· Always read their Medicare Summary Notice (MSN) or Explanation of Benefits (EOB). The words “gene analysis” or “molecular pathology” as service codes may indicate questionable genetic testing

· Refuse the delivery of any genetic testing kit that was not ordered by their physician

· Contact their local SMP for help. SMPs empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse.

The Senior Medicare Patrol (SMP) is available to provide consumers with the information needed to protect against Medicare fraud, errors, and abuse; detect potential fraud, errors, and abuse; and help consumers report concerns.

For additional information, contact Nevada Senior Medicare Patrol at (888) 838-7305 or SMPinfo@adsd.nv.gov

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