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up front Saturday 28 September 2019
Feds crack Medicare gene test fraud that peddled cheek swabs

Continued from Front incomprehensible. Medi-
care paid out hundreds of
Fraudsters preyed on peo- millions of dollars before
ple’s fears of harboring ge- authorities detected the
netic markers for diseases fraud and moved in.
such as cancer. However, There was no single orga-
genetic testing is not rou- nization behind the fraud
tinely used to screen for and Friday’s operation
cancer. went after several regional
“A decade ago, it would networks.
have given Medicare ben- Medicare enrollee Linda
eficiaries pause if someone Morris of Parker City, Indi-
wanted to get a swab from ana, said she was roped in
their cheek of their saliva,” at a conference on aging
said Shimon Richmond, well. The retired high school
who heads the inspector math and journalism teach-
general’s investigative divi- er got her cheek swabbed
sion . “Today people know by one of the many health
and recognize what (ge- vendors at the event.
netic testing) is, and they “Their ploy was, ‘Get a Linda Morris looks over her Medicare statements, Wednesday, Sept. 25, 2019, in Parker City, Ind.
think ‘I can get that done, mouth swab and we can Associated Press
and I can get it done for analyze how well your sys- most effective tool. “These a pervasive problem that is required to pay medical
free and find out if I have tem synthesizes the drugs are bad actors trying to costs taxpayers tens of bil- bills promptly, which means
health issues that I need to you are taking,’” she said. take advantage of good lions of dollars a year. The money often goes out be-
address.’” “It never crossed my mind medicine,” she said. true extent is unknown. fore potential frauds get
It’s a bad decision, said there was anything wrong Fraud against government Experts say part of the flagged. Investigators call
Richmond. Not only does it with this.” health care programs is problem is that Medicare that “pay and chase.”q
put the patient’s Medicare Then her Medicare state-
ID in the hands of fraudsters ments started coming in,
who can then keep resell- showing charges as high as
ing it for illicit purposes, but $33,000. The program paid
it can potentially compro- almost $10,000.
mise unique details of an Morris said she was never
individual’s make-up. billed, and was never sent
Another downside: Medi- results. When she looked
care might deny future up the address for the test
coverage for genetic test- vendor it was “a house on
ing when it’s really need- a back road.”
ed, since the patient’s re- “I feel stupid, and in the
cord would show such an meantime, I’m furious,”
analysis was already done. Morris said. Health fairs,
Patients should only have church events, and senior
genetic testing if their own centers are like magnets
doctor orders it, officials for the fraudsters, officials
said. said.
The alleged scam worked Dennie Krivokapich of
like this: Officials said a Farmington, New Mexico,
telemarketing or in-person said he almost sent in his
“recruiter” would convince cheek swab following a
a Medicare enrollee to telemarketing pitch. The re-
take a genetic test, assur- tired accountant is a three-
ing them that the program time cancer survivor and
would pay the full cost. The concerned about his future
patient would provide their risk. The company sent him
Medicare information. A a kit, but the paperwork
doctor in league with the that came with it made
fraudsters would approve him suspicious.
the test, and collect a kick- “The physician who re-
back from the recruiter quested it was not my phy-
company. A lab participat- sician,” said Krivokapich.
ing in the scheme would The marketing company
run the test, bill Medicare, kept calling him, until he
and share payments col- blocked the number.
lected from the govern- Government-backed anti-
ment with the recruiter.Bills fraud organizations known
to Medicare connected as the Senior Medicare
with the scheme typical- Patrol have been trying to
ly ranged from $7,000 to spread the word about ge-
$12,000, Richmond said, netic testing scams. Retired
with some much higher. federal investigator Jen-
In many cases the patient nifer Trussell, a consultant
never got a report back, or to the groups, said fear of
the results provided were cancer is the scam artists’