May 6, 2019
Genetic Testing Scam Continues in Illinois and Nationwide 
The Illinois SMP at AgeOptions continues to hear more and more about genetic testing scams targeting Medicare beneficiaries. Companies are showing up at health fairs, approaching people at Medicaid offices or calling beneficiaries at their home offering “free” genetic testing in exchange for their Medicare number.

AARP recently ran an article about these genetic or DNA tests Medicare scams. As noted in the article, this is a nationwide problem. Also, Medicare has recently clarified that its coverage of tests like these are meant for people with very advanced stages of cancer already seeking cancer treatments. Read the full AARP article here to hear from beneficiaries targeted by this scam.

Remember that only your doctor should prescribe healthcare tests or services like these.

If you have been approached by a genetic testing company in person or over the phone, please call the Illinois SMP at AgeOptions (800)699-9043.
Talking with Your Doctor about Fraud
The Illinois SMP always recommends that you work with your doctor to prevent healthcare fraud. A trusted doctor who knows your healthcare needs can order tests, equipment or other services to meet those needs. But how do you have conversations with your doctor about your healthcare needs and fraud?

The National Institutes of Health (NIH) offers tips and recommendations for talking with your doctor, including asking questions about your health and understanding your diagnosis and treatment that you can read here .

Here are some additional tips for talking with your doctor about fraud:

  • Talk about pain management. Pain is not an inevitable part of aging. Fraudsters often ask if you have pain to get you to agree to take braces or other treatments. But if you want pain relief, bring this as a concern to your doctor.

  • Bring your MSN to your appointments. Your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) is a tool meant to help you understand the care Medicare or your insurance is paying for. If you want to understand it better, you can ask your doctor or their staff. (Just remember that the “Amount Provider Billed” is not what Medicare paid - look to “Medicare Approved Amount.”)

  • Keep your doctor aware of healthcare fraud. Tell your doctor about the calls you are getting or the vendors you encounter that try to take your Medicare number. Share these Fraud Alerts with your doctor. They may know that fraud is happening, but it is important to know that is happening to their patients and how often it is happening.

Have a wonderful week!

Travis Trumitch
Please share this Fraud Alert with colleagues, consumers, or other professionals in your area. If you would like to sign up to receive the Fraud Alert directly, visit click here.

This project was supported, in part by grant number 90MPPG0036, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.
The Illinois SMP at AgeOptions partners with agencies across the state to empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education.

Please share this Fraud Alert with colleagues, consumers, or other professionals in your area and visit our website to sign up for our Fraud Alert email list.