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DNA testing scams are costing Medicare billions

DNA testing scams are costing Medicare billions

Increasing numbers of US citizens are uploading their DNA data to public ancestry websites. Millions of Americans have already published their genetic information, and hundreds more do so every week. But, as DNA testing continues to grow in popularity, a key concern is unscrupulous healthcare marketers that are preying on unsuspecting elderly citizens for DNA samples, say federal authorities.

The concern is that some of these DNA samples are passed to clinical laboratories, which are alleged to pay kickbacks for the referrals to fleece the federal Medicare program for costly genetic tests that patients largely don’t need – or even know are being billed in their names. According to the Miami Herald, this is the fastest-growing area of Medicare fraud. And it’s costing the US government billions in taxpayer dollars.

Genetic healthcare testing, which involves the examination of a person’s DNA to predict risks for diseases such as cancer and dementia, is rife with corruption by racketeers. The Justice Department recently announced 35 suspects accused of fraudulently billing $2.1 billion to Medicare. Among those arrested were nine doctors accused of writing prescriptions in exchange for kickbacks.

Fraudulent genetic testing

Federal law enforcement and regulatory agencies first started seeing an increase in fraudulent genetic testing claims to Medicare 5 years ago. And in 2018, complaints soared to 50 a week compared to one a week, said Shimon Richmond, Assistant Inspector General for Investigations in the Office of Inspector General at the Department of Health and Human Services. Genetic testing scams are a pervasive problem all over the map, he said, which has prompted the federal agency to start issuing fraud alerts over the summer.

“This is an ever-growing problem because of the intersection of technology and medicine”, Richmond told the Miami Herald. “It’s a big challenge. … We’re trying to ensure that legitimate tests are covered while preventing as much of this fraud as possible.”

One federal indictment involved a Gainesville doctor ordering genetic tests for hundreds of patients, mostly from New Jersey. These patients received $75 gift cards from marketing companies to persuade them to turn over their DNA cheek swabs to labs that billed Medicare. Last year, the federal program paid a network of labs about $4.6 million for genetic tests that the Gainesville doctor allegedly ordered without seeing the patients. Five people operating telemedicine companies and labs were also charged in the fraud conspiracy.

This week, the owner of a Tampa medical marketing company was sentenced to nearly 6 years in prison for providing DNA swabs from Medicare patients in Miami to a lab for genetic testing. The patients were given food and other inducements to provide the swabs in the $2.2 million Medicare fraud scheme. The Tampa business owner paid kickbacks to the Miami clinic owners and received similar payments from the lab for his referrals, according to the Justice Department. The Miami patients never saw the test results.

Federal prosecutors have filed similar genetic testing cases in Georgia, South Carolina, Texas and Louisiana as part of the latest Medicare fraud take-down.

DNA testing Florida

Florida, especially the Miami and Tampa areas, have long been recognized as incubators for all types of Medicare fraud.

The Florida Department of Elder Affairs (DOEA) has received a federal grant of nearly $500,000 to work with about 500 Senior Medicare Patrol volunteers across the state to educate and warn senior citizens about genetic testing scams.

Anne Chansler, the DOEA’s Director of Elder Protection, said senior citizens should be on guard against any healthcare vendors who try to solicit DNA cheek swabs under any circumstances, whether it be in a supermarket parking lot, at a health fair, or over the internet.

“The reach is endless”, she said, referring to the locations visited by unscrupulous vendors targeting seniors. “If it’s not your doctor, don’t do it. … Never give out your Medicare information.”

If anyone is concerned about a family history of diseases, such as cancer or dementia, a Medicare beneficiary should consult with a doctor, undergo an evaluation, have the cheek swab done and review the lab results with the physician, she said. Anyone who has had a cheek swab done without a physician should report it to state or federal authorities.

Chansler said that senior citizens not only run the risk of being exploited for Medicare fraud but that their identities and Social Security numbers could be used for financial scams. A hotline for Medicare fraud has been set up at 1-800-HHS-TIPS.

AlphaBiolabs wants to reassure its clients that it does not store personal data including DNA profiles. We also don’t sell on any information. You can read more about our privacy and DNA testing here.

To find out about our range of DNA testing services call us now on 727-325-2902 or email info@alphabiolabsusa.com