Genetic Testing Scam Alert

By Kim Hill, Economic Security Client Services Manager at Elder Law of Michigan

The U.S. Department of Health and Human Services Office of Inspector General has issued a Medicare fraud alert involving genetic testing kits. Fraudulent companies are offering Medicare beneficiaries access to a free screening for cancer, Parkinson’s or other conditions, claiming that Medicare will cover the cost. These companies find their victims through phone calls, public events like health fairs, and home visits to make their sale. Once the beneficiary’s Medicare number is obtained, these companies can use it for this or any other type of Medicare fraud.

The truth is that Medicare will only cover certain cancer screenings if they are ordered by a physician. Information on the screenings that Medicare covers can be found in Your Guide to Medicare Preventive Services. Even then, there are conditions that need to be met by the patient, such as age or predisposition to cancer. Screenings can only be ordered once every 12 – 36 months, depending on the test.

How can beneficiaries protect themselves from potential Medicare fraud?

  • Do not share your Medicare number or any personal information with anyone other than your physician’s office.
  • Any cancer/genetic testing should only be requested by your trusted physician.
  • Check your Medicare Summary Notice (MSN) for questionable charges. The MSN is sent every three months to beneficiaries and lists all services, supplies, and the cost that was billed to Medicare.

If you have questions or suspect that you have been a victim of fraud, you can contact your state’s Senior Medicare Patrol (SMP), a non-profit organization funded by the U.S. Department of Health and Human Services and the U.S. Administration for Community Living. The SMP can help determine if fraud or abuse is suspected and walk you through the process of reporting it to the appropriate state and federal agencies. Check the SMP website for more information and resources on other types of Medicare-related fraud.

Kim Hill facilitates Economic Security Client Services at Elder Law of Michigan and has been a member of the Elder Law team since March 2005. As an Economic Security Client Services Facilitator, Kim provides general support to MiCAFE staff and Community Partners through one-on-one training and policy research. She also organizes educational outreach mailings, maintains various MiCAFE staff schedules, and other administrative projects as they arise.