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Health Care Buzz: Scams — genetic testing fraud

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About Medicare Genetic DNA Testing Fraud

Some labs are offering a cheek swab for genetic testing as part of a “free” health screening at events like local health fairs in order to obtain Medicare beneficiaries’ information for identity theft or fraudulent billing purposes.

We’re also aware of third parties offering to pay agents if they help to facilitate Medicare beneficiaries completing genetic tests. Here is an example of what an invitation from a third party looks like.

What Should Medicare Clients Know About Genetic Testing?

Clients should always confirm that their test has been ordered by their doctor, that it’s covered by their plan, and that it’s medically necessary. Also, beneficiaries should never give out their Social Security, Medicare/health plan numbers or banking information to someone they do not know. In addition, your clients should never consent to any lab tests without their doctors’ orders. Please advise your clients to call the customer service number on the back of their ID cards to discuss coverage or other concerns.

If a client asks about the testing, advise them to discuss it with their primary care physician (PCP). A great resource regarding the National Coverage Determination (NCD) for the testing is located on CMS.gov. This is a worthwhile guide to have on hand and for reference as questions come up. The best rule of thumb when discussing any type of testing with your client is to always refer them to their PCP.

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