Get Ready to Fight Medicare Fraud: New Scam Alert
By Oklahoma Insurance Commissioner Glen Mulready
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Over the last 25 years, we’ve witnessed amazing advances in science and medicine. What was once thought impossible is now being accomplished. Genetic testing is one example. With a small sample of saliva, your risk for certain diseases can be predicted. Unfortunately, just as technology has evolved with these tests, so have the opportunities for scammers.
This month, the U.S. Department of Health and Human Services Office of Inspector General sent out an alert about fraud schemes involving genetic or DNA testing. These scams have been targeting Medicare beneficiaries through phone calls, booths at public events, health fairs and door-to-door visits.
A typical scheme might go something like this: A scammer offers free ice cream or gift cards at a retirement community, senior nutrition center or Medicare expo for anyone who listens to a pitch about free DNA testing. It’s important to know: Medicare will pay for genetic testing for patients with advanced cancer or a family history of certain types of cancer if the test is medically necessary and is ordered by a treating physician. The fraudster will usually downplay or even ignore the medical necessity criteria and the need for a doctor’s order.
The scammer may swab a person’s cheek right there to collect saliva and gather identifying information, such as a person’s name, date of birth and Medicare number. Medicare beneficiaries have also been sent genetic testing kits and asked to return the completed kit with their insurance information. This is so the scammer can bill Medicare thousands of dollars of expensive and medically unnecessary genetic testing.
How do you tell the difference between a genuine, medically-necessary genetic test and these fraud schemes? Talk to YOUR doctor about it. This is the person with whom you’ve placed your trust regarding your healthcare.
Here are some things you can do to protect yourself from this scheme:
- If a genetic testing kit is mailed to you, don’t accept it unless it was ordered by your doctor. Refuse the delivery or return it to the sender. Keep a record of the sender’s name and the date you returned the items.
- Be suspicious of anyone who offers free genetic testing and requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes.
- Look for charges on your Medicare Summary Notice statements for unnecessary tests or screenings that you did not want or were not ordered by your doctor.
If you suspect that you’ve been a victim of this scam or any Medicare fraud, report it. Call the Oklahoma Insurance Department’s Medicare Assistance Program at 800-763-2828.