Last Friday, the U.S. Department of Justice charged 35 individuals allegedly involved in a fraudulent genetic testing scam targeting people 65 and older. This is said to be one of the largest healthcare fraud schemes in U.S. history, costing the Medicare program more than $2 billion. The charged individuals are accused of schemes involving laboratories making illegal payments to physicians and nurse practitioners and worked with fraudulent telemarketers to offer free genetic testing to Medicare beneficiaries. The targeted patients gave up private health information and Medicare identification and often didn’t receive their test results.
Genetic testing is complicated, which makes it important to have a medical professional with specialized training in genetics, like a genetic counselor, involved in the process. A genetic counselor not only can help patients determine if testing is right for them and interpret their results, but they also help identify fraudulent practices.
Genetic counselors suspected fraudulent practices as Medicare patients were referred to them with test results from unfamiliar sources that proved to be unreliable upon further inspection. Many of these patients were not appropriate candidates for testing. The National Society of Genetic Counselors (NSGC) provided its membership with information about how to report suspected fraud to the U.S. Health and Human Services Office of the Inspector General (OIG). The Society also hosted a webinar this past June for members aimed at understanding the federal fraud and abuse laws and regulations and emphasized how to report suspected fraud.
Amy Sturm, MS, CGC, LGC, NSGC President, states, “It’s tragic to hear when patients are being taken advantage of by medical professionals who are the people they should be able to trust most. Involving a genetic counselor in the genetic testing process can help reduce these types of fraudulent cases, ensure that patients are receiving appropriate care and inform them about who is receiving their personal health information.”