Aging Well: state warns seniors about genetic testing fraud
HONOLULU - There's a frightening new scam that's starting to surface in Hawaii, and it's targeting seniors. The state says there's a double whammy to this one: It not only costs victims thousands of dollars, but it also puts them at risk for identity theft.
Kaipo Cullen and Hannah Hall are going over the latest scam to target Hawaii seniors. This one involves the offer of genetic testing, specifically, "medical lab tests to determine if someone is predisposed to certain diseases like cancer, Parkinsons, or dementia," Cullen expands. These tests can also be referred to as DNA screenings, cancer screenings, and hereditary testing, to name a few.
Cullen is a program manager at Senior Medicare Patrol Hawaii, part of the state's State Executive Office on Aging. It teaches seniors how to protect themselves from scams like this, which she elaborates starts with "a representative of a genetic testing company. They go into a senior center and they pitch the wonderful benefits of DNA testing. On the spot, they pass out cheeks swabs." The representatives, she says, also go to senior housing, health fairs, and even parking lots to convince people to let them take a cheek swab for testing. They advertise on TV and online.
At the same time, the fraudster collects victims' Medicare number, saying they'll bill insurance. Because confusion exists regarding Medicare’s coverage for genetic tests for cancer and other conditions, the Office of Inspector General (OIG) released a fraud alert on the topic. It advises the public to be suspicious of anyone who offers free genetic testing and then requests their Medicare number.
The State Executive Office on Aging says the labs and the people approaching the seniors work together to find victims. A key part of the fraud is, the scammers tell seniors Medicare will pick up 100% of the lab test costs. The state says, it doesn't.
Cullen says Medicare usually denies payment, leaving the senior on the hook. Make no mistake, she says. These are not like the very common and relatively inexpensive 23 & Me or Ancestry.com DNA test kids. "These are really expensive tests. They range from $6,000 to $12,000 a shot," she says.
Worse, it leaves the victim open to medical identity theft. Hannah Hall is a volunteer with Senior Medicare Patrol Hawaii, which is starting a series of public seminars to educate seniors about this fraud. "This is ridiculous. This is just taking advantage of people wanting to know about their own health," she huffs.
The 70-year-old Hall's role with SMPH is teaching her peers how to stay safe. She says it can be easy to believe schemers. "They look all sharp and they're going, 'Molecular pathology,' and you say, 'Oh, that sounds big,'" she exclaims, recalling some victims' responses.
It is big, Hall says - a big headache for people who fall for it. The state reminds people to be suspicious of anything free, and never give your medical information to strangers.
How to protect yourself:
The OIG’s fraud alert states that only a trusted physician should approve any requests for genetic testing. In fact, federal regulations state that diagnostic tests must be ordered by the physician who is treating the beneficiary – in other words, the person’s own doctor. “A doctor who has never met or examined a patient, often hired by a genetic testing company, should not be signing off on any tests. That’s a red flag,” said Cullen.
The SMP recommends that Medicare beneficiaries:
• Refuse to give out their personal information or accept screening services, including a cheek swab, from someone at a community event, a local fair, a farmer’s market, a parking lot, and/or any other large event.
• Go to their own doctor to assess their condition, not a doctor on the phone they’ve never met from a company they don’t know.
• Always read their Medicare Summary Notice (MSN) or Explanation of Benefits (EOB). The words “gene analysis” or “molecular pathology” as service codes may indicate questionable genetic testing.
• Refuse the delivery of any genetic testing kit that was not ordered by their physician.
• Be suspicious of anyone who offers free genetic testing and then requests their Medicare number. If their personal information is compromised, it may be used in other fraud schemes.
• Contact their local SMP for help. SMPs empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse.
SPH Hawaii says it's aware of two cases in Hawaii in the last two months, but there may be more. If you feel you've been targeted, or have been approached to host a genetic testing presentation, report it to Senior Medicare Patrol Hawaii. The toll free phone number is 1-800-296-9422. The website is smphawaii.org.