A genetic scam is sweeping the nation, and last month we got caught up in it.
The folks who attended the Successful Aging Expo in Auburn on May 30, 2019, know that we’re concerned that a company providing cheek swabs as part of a genetic testing profile might be involved in a Medicare scam.
WHAT IS THE SCAM?
Older adults at senior centers, housing complexes, and community events are targeted by companies promoting “free” genetic testing, cancer screening, or DNA testing. During the event, older adults are asked to swab their cheek to collect a DNA sample which will be sent to the lab for analysis. They are told that the test will be covered completely by Medicare, and all that is needed to process it is their Medicare number.
NOW WE KNOW:
- Medicare only pays for DNA or genetic testing in rare circumstances where it is medically necessary for treatment or diagnosis of a medical condition.
- These tests must be ordered by the patient’s own physician.
- There must be documentation in medical records to substantiate the need for the testing.
- The company involved told substantial lies in order to get people to have their cheek swabbed and fill out the information forms, which included their Medicare number.
WHAT WE FEAR:
- We’re concerned that the genetic tests will be run, but Medicare will deny the claim, which may open people to large lab and testing bills.
- We’re concerned that people’s Medicare and personal information will be sold or shared without permission, opening people to other fraudulent Medicare claims or ID theft.
Genetic testing fraud is simply another trend in a long line of fraud, waste, and abuse examples within the arena of laboratory services. The Office of the Inspector General has a webpage on genetic scams.
WHAT TO DO NOW:
- Make sure your senior center, senior community, church group or other group focused on older Mainers does not allow “visits and free testing” from these companies. If you question what is covered under Medicare, call Medicare or your plan advisor.
- If you think you might be involved in a scam, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Medicare is open 24 hours a day 365 days/year so a beneficiary can file a complaint or express a concern any time of day. You can also file a report on-line.
- Call your primary care physician and alert the office. Scammers need permission from your PCP to get the test covered under Medicare.
- Check your Medicare summary of services carefully. If there is a Medicare claim rejection for this genetic screening, keep the information. Contact Gloria Rhode, Senior Medicare Patrol Project Statewide Coordinator at Legal Services for the Elderly (207) 621-0087 if you receive any correspondence from the genetic testing lab.
- Kerry Faria at SeniorsPlus in Lewiston is also aware of this issue and can offer advice if necessary.
- If you haven’t already, because of previous identity theft scares, freeze your credit. This article tells you how.
- Ask your bank and credit card company to be on the watch for any suspicious activity.
- Share this information with others.