scams

What is Healthcare Fraud and Abuse?

“What is healthcare fraud and abuse?” is a question that unfortunately can be answered in a number of ways.

The latest scam is one involving DNA testing.

The Area Agency on Aging sent out an alert on May 13, 2019 about this latest scam. Companies are attending senior health fairs and promoting “free” genetic testing, cancer screening, or DNA testing. The company takes a mouth swab of the senior to purportedly do the testing. The companies claim that Medicare will pay for the screening and are obtaining the Medicare numbers of the seniors that they are scamming. This scam is resulting in fraudulent charges and leaving many Medicare beneficiaries liable for significant charges.

DNA testing

Seniors should be aware that all diagnostic x-rays, laboratory tests, and other diagnostic tests must be ordered by the physician who is treating the beneficiary.

Since the senior’s physician is not at the health fair ordering the testing, Medicare will not pay. Medicare only covers one genetic test to screen for a cancer: Cologuard, a colorectal cancer screening test available only by prescription. The posturing of any other genetic test as a Medicare-covered screening benefit (available for free no less) should send up a red flag as a scam.

This DNA scam is just the latest of the scams to which seniors may fall prey. We have addressed the question “What is Healthcare Fraud and Abuse?” in the past here. Other scams include people pretending to be the IRS (collecting back taxes) or people pretending to be grandchildren who need money while traveling.

Seniors sometimes make themselves vulnerable to fraud schemes by sharing financial worries in public. If a con artist hears such worries, he knows that he has a vulnerable target. Scams may be reported to the Collier County Sheriff’s Office Senior Advocacy Unit at 239-252-0230 or email at seniors@colliersheriff.net.

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