The FBI reports that scammers often target older Americans because seniors “tend to be trusting and polite,” have good credit, and have accumulated savings. Swindlers also count on seniors to resist reporting a scam because seniors may worry that relatives will view them as incapable of managing their finances if they admit they were defrauded.
Fraudulent Cancer Screening Tests
The FBI and the Department of Justice have attempted to eradicate a fraudulent scheme involving genetic screening tests for cancer. The scheme targets Medicare recipients. Telemedicine companies and genetic testing laboratories engaged in a telemarketing scheme to dupe Medicare beneficiaries into signing up for unnecessary genetic tests.
Medicare does not typically cover genetic testing unless (1) the patient has cancer, (2) the test is ordered by a treating physician, and (3) the test is conducted by a certified laboratory. The Department of Justice charged the companies with prescribing genetic testing, “either without any patient interaction or with only a brief telephonic conversation with patients they had never met or seen.” The fraudulent schemes resulted in losses to Medicare of more than one billion dollars.
As a DOJ prosecutor explained, pitches for cancer screening tests prey on the fears of older Americans. While genetic testing may identify an inherited susceptibility to certain kinds of cancer, it is typically recommended only after genetic counseling is “performed by a trained genetic counselor or other health care professional who is experienced in cancer genetics.”
Consumers should be wary of an out-of-the-blue telephone call promising a “free” genetic test that will be paid by Medicare. Consumers may never receive the test results. When they are provided with test results, they generally regard the results as useless. The doctors who prescribe the tests are paid by the companies that bill Medicare. They make no attempt to explain the results to the consumers who were swabbed. They usually have no contact with the patient at all.
The AARP has warned consumers to avoid individuals who ask to take a cheek swab for genetic testing. Medicaid recipients in Louisville were offered $20 in exchange for a DNA sample and insurance information. In Nebraska, scammers visited senior centers, residential communities, and assisted living facilities “offering to swab people’s cheeks for genetic material for purported DNA cancer checks.”
In most cases, the scheme used innocent recipients of Medicare or Medicaid to defraud the government. There have been reports, however, of genetic testing labs billing consumers as much as $1,000 after Medicare or Medicaid declined to pay for the “free” test. The DOJ also warned that some consumers were victims of identity theft.
The Screening Test Scam Resurfaces
A nationwide DOJ crackdown on genetic testing fraud two years ago was designed to put an end to genetic testing fraud. Medscape reports that the scheme continues to target seniors.
Since the pandemic has prevented perpetrators of the scheme from visiting senior centers and health fairs, they place greater reliance on telemarketing. A “new wrinkle” in the scam, according to Medscape sources, is that seniors are more often billed directly for the screening kits when Medicare rejects a claim.
The pandemic has also given birth to a variation of the fraudulent scheme. Medscape warns that genetic testing schemes may now be targeting heart disease, a common complication of a COVID-19 infection. A fear of heart disease, like a fear of cancer, makes some seniors susceptible to the genetic testing scam.
The bottom line is that seniors should view any telemarketing call with suspicion. The best practice is to give telemarketers a prompt “not interested” and hang up the phone. If a telemarketer promises anything that is “free,” it pays to remember Thomas Moore’s advice: If things seem “too good to be true, they are probably the wrong thing to take.”