Medicare Watchdogs Issue Urgent Warning
Medicare watchdog organizations across the country are raising serious concerns about a troubling trend targeting older Americans: genetic testing scams. These sophisticated schemes are specifically designed to exploit seniors’ health concerns while fraudulently billing Medicare for thousands of dollars in unnecessary tests.
Understanding the Deceptive Tactics
Scammers approach seniors with seemingly generous offers of “free” genetic testing or tests available “at no cost to you.” They create a false sense of urgency by claiming these tests can detect various diseases, including cancer, autoimmune conditions, and other serious health issues. The reality is far different – these tests are rarely medically necessary or covered by Medicare.
“These predatory companies target vulnerable seniors, convincing them to undergo genetic testing that Medicare typically doesn’t cover,” explains healthcare fraud expert Maria Alvarez. “If Medicare denies these claims, as they usually do, the company might then turn around and bill the patient directly for amounts ranging from $9,000 to $11,000.”
Red Flags to Watch For
Several warning signs can help seniors and their families identify potential genetic testing scams:
- Companies arranging “telemedicine” consultations with unfamiliar doctors specifically to order genetic tests
- Unexpected charges on your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) for genetic tests you don’t remember requesting
- Billing for pharmacogenetics tests unrelated to any medications you currently take
- Individuals requesting your Medicare number at community locations such as health fairs, senior centers, assisted living facilities, farmers markets, parking lots, or church events
How These Scams Work
The typical genetic testing scam follows a predictable pattern. Scammers first gain trust by appearing legitimate and knowledgeable about healthcare. They then collect Medicare information and arrange for unnecessary genetic testing. After submitting inflated claims to Medicare, they either collect payment from the government program or, if denied, attempt to bill seniors directly for substantial amounts.
Protecting Yourself and Reporting Fraud
Medicare beneficiaries should remain vigilant about protecting their personal information. Never share your Medicare number with unfamiliar individuals or companies, regardless of how legitimate they may appear. Always consult with your primary care physician before agreeing to any genetic tests, ensuring they’re medically necessary and properly ordered.
If you suspect you’ve encountered a genetic testing scam or notice suspicious charges on your Medicare statements, report it immediately to the New York State Senior Medicare Patrol (SMP). This organization specializes in addressing Medicare fraud cases and can provide guidance on next steps.
The Growing Concern
As genetic testing becomes more widespread in legitimate healthcare settings, scammers increasingly exploit this trend to target seniors. By staying informed about these tactics and knowing how to identify red flags, older Americans can better protect themselves from becoming victims of these costly Medicare scams.
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