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February 20, 2019 Fraud & Scams

Genetic Testing Fraud Alert

Watch out for the latest Medicare scam— DNA/genetic testing schemes!

Each year, the Medicare program loses $60 billion to fraud. The best way to reduce this figure is beneficiary education to prevent and reduce known pathways to fraudulent activities and unethical billing practices.

The Wisconsin Senior Medicare Patrol staff have been hearing about DNA and genetic testing schemes in other parts of the country, and we recently learned that they are starting here in Wisconsin.

What Is The Scam?

Older adults at senior centers, housing complexes, and other community locations are targeted by companies promoting “free” genetic testing, cancer screening, or DNA testing. These screenings are frequently done under the guise of an ice cream social event. 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 then told that the test will be covered completely by Medicare, and all that is needed to process it is their Medicare number.

Are there other variations of this scam?

Yes. Sometimes Medicare beneficiaries are being contacted at home by phone and told that they will be sent a DNA testing kit in the mail. In this case, the person is asked to perform the cheek swab at home and then return the kit in the mail for DNA analysis. The caller then asks for the person’s Medicare number and reiterates that there will be no charge to the beneficiary.

Be Aware:
  • 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.
What Should I Do?
  • If you are contacted by phone, hang up! Do not answer any questions or give out any personal information or your Medicare number.
  • Contact the Wisconsin Senior Medicare Patrol at (888) 818-2611 to report any related activities or suspicious requests for your Medicare number.
  • Remember that Medicare will not call you to confirm your personal information, your Medicare number, or ask questions about your health.
  • Report Medicare marketing violations—Medicare does not allow door-to-door sales or unsolicited contact with Medicare beneficiaries.
What can ADRCs, senior centers, independent living centers, and others do to help?
  • Spread the word about Medicare fraud. Distribute SMP flyers and contact information.
  • Screen any groups or people who want to give presentations to older adults.
  • Do not allow speakers to collect personal information or Medicare numbers from attendees.
  • Request Wisconsin Senior Medicare Patrol staff give a presentation to your group to educate beneficiaries on Medicare fraud.
  • Do not agree to host an ice cream social or other event involving DNA or genetic testing.