Thieves Use DNA Testing to Steal Identities and Defraud Medicare
Thieves in several states are reported to be committing identity theft and fraud by using DNA-testing to trick elders living in senior centers and assisted living communities into disclosing personal information and/or participating in unnecessary medical services. The identity thieves then use that personal information to bill Medicare and Medicaid for reimbursement of those services.
This scam may be the result of last yearās announcement by the Centers for Medicare & Medicaid indicating that Medicare would cover genetic evaluation of cancer by FDA-approved tests. Another possible contributing factor to the success of these schemes may be coming from peoplesā growing interest in their ancestry, learning some basic health information, and consumer-marketing of genetic tests.
An Attorney General in Kentucky shared a report from residents that indicated some individuals operating out of a van were going around in some low-income neighborhoods offering to pay Medicaid recipients $20 for DNA swabs and their personal health insurance information.
Authorities also reported postings on Facebook urging people to go to locations where they could receive free cancer screenings plus $20. The perpetrators have also falsely identified themselves as being affiliated with a Medicaid insurer and other official sounding providers.
Compensating people to participate in medical tests and services may also be considered a violation of federal anti-kickback laws.
Compliance Perspective
Failing to prevent unscrupulous schemersā from gaining access to a facility and the residents in order to steal personal information and solicit participation in unnecessary medical services designed to defraud Medicare/Medicaid may be considered a violation of residentsā rights to be free from misappropriation and exploitation.
Discussion Points:
- Review policies and procedures for screening of individuals seeking access to the facilityās residents.
- Train staff to recognize and report potential intruders seeking to gain inappropriate access to the residents.
- Periodically audit for compliance with protocols for controlling access to the building and the residents. Consider informing residents and family members via a printed notice or through a residentsā council meeting of this scheme to steal personal identities by using fraudulent DNA testing schemes.
