Medicare Fraud Alert: Genetic Testing Scam

Chris Hagerstrom, Executive Director of Communication and Training

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From the U.S. Department of Health and Human Services, Office of Inspector General, “Fraud Alert: Genetic Testing Scam” – Updated August 13, 2019.

The US Department of Health and Human Services Office of Inspector General is alerting the public about a fraud scheme involving genetic testing.

Genetic testing fraud occurs when medicare is billed for a test or screening that was not medically necessary and/or was not ordered by a Medicare beneficiary’s treating physician.

Scammers are offering Medicare beneficiaries “free’ screenings or cheek swabs or genetic testing to obtain their Medicare information for identity theft of fraudulent billing purposes. Fraudsters are targeting beneficiaries through telemarketing calls, booths at public events, health fairs, and door-to-door visits.

Beneficiaries who agree to genetic testing or verify personal or Medicare information may receive a cheek swab, an in-person screening or a testing kit in the mail, even if it is not ordered by a physician or medically necessary.

If Medicare denies the claim, the beneficiary could be responsible for the entire cost of the test, which could be thousands of dollars.

Protect Yourself

  • If a genetic testing kit is mailed to you, don’t accept it unless it was ordered by your physician. Refuse the deliver 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 you “free” genetic testing and then requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes.
  • A physician that you know and trust should assess your condition and approve any requests for genetic testing.
  • Medicare beneficiaries should be cautious of unsolicited requests for their Medicare numbers. If anyone other than your physician’s office requests your Medicare information, do not provide it.
  • If you suspect Medicare fraud, contact the HHS OIG Hotline.

Chris Hagerstrom, Executive Director of Communication and Training

Chris Hagerstrom is the Executive Director of Communication and Training at Jack Schroeder and Associates, LLC. Through years of experience he has become an expert with Medicare, Life, Health, Annuities and Supplemental Health and how to successfully navigate the independent agent market.

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