FRAUD ALERT by U.S. Dept. of Health & Human Services (DHHS)

FRAUD ALERT by U.S. Dept. of Health & Human Services (DHHS)

This alleged scam specifically targets the senior population across several states. “Marketing representatives” are visiting senior-living communities, such as assisted living and residential care facilities, as well as, other various locations where the senior population often congregate and offer to perform genetic testing for the purpose of disease detection and prevention. These individuals are using personal information collected from those who participate for identity theft and fraudulent billing purposes.

Additional information regarding this scam is noted in the text below, as well as, the links to the two recent articles discussing the scam in detail.

DHHS Fraud Alert:
https://oig.hhs.gov/fraud/consumer-alerts/alerts/geneticscam.asp

Impact across many states:
https://www.insurancejournal.com/news/nation/2019/04/18/524185.htm

The scammers typically try to determine if the person has Medicare or Medicaid and might host an event, such as bingo with prizes or food, to entice the residents to participate. Sometimes announcements are made to all residents over the building’s intercom system in order to attract them to the event.
They may be dressed in scrubs or white coats to give the appearance they are a health care professional and in some cases, they may indicate they represent a medical research facility.
The victims are usually asked to complete a questionnaire and ask whether any of the individual’s relatives have had cancer or other diseases. They indicate a genetic test can be conducted to determine if the individuals already have a disease, or if they are susceptible to acquiring a specific condition. In some cases, they indicate the test will tell whether the combination of prescription and over the counter medications the individual is taking may have undesired interactions or adverse effects on their metabolism.
If the individual agrees to be tested, the representative obtains their Medicare of Medicaid numbers and uses a swab to take a saliva sample from inside their mouth. The individual may to may not be asked to sign the questionnaire and they are typically told the test results will be sent to them in several weeks, usually somewhere between four and eight weeks. The individual may or may not receive the results of a lab test later.

DHHS OIG is investigating the scheme in several states, including Missouri. The MMAC investigations Unit and Missouri Medicaid Fraud Control Unit (MFCU) would like to know about Missouri seniors who are on Medicare or Medicaid and have been contacted by genetic testing representatives. The seniors, or their representatives/family, can contact MMAC Investigations Unit at (573)751-3285 or MMAC.ReportFraud@dss.mo.gov