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Genetic testing facilities face allegations of health care fraud

| Sep 30, 2019 | Health Care Investigations |

The Office of Inspector General with the United States Department of Health and Human Services (HHS) recently released a consumer alert to warn the public about a potential health care fraud scheme.

What is the latest warning?

The alleged scheme, according to the government, involves the use of genetic testing that is not medically necessary. The company behind the genetic testing then bills Medicare for the services.

In a recent publication, the HHS explains that those running the businesses in question offer Medicare beneficiaries a “free” screening. The screening could take the form of a cheek swab or other, relatively easy, exam. In exchange for the exam the beneficiary can receive information about their genetic predisposition to cancer or other diseases.

HHS states the service is a scam. The agency states the business is working to gather Medicare information for fraudulent billing purposes. HHS encourages beneficiaries to “be suspicious” of anyone that offers a free test and then asks for the beneficiary’s Medicare number.

What can other business owners learn from this investigation?

The investigation is an example of the diversity of cases the government will investigate. Any business that bills Medicare can find themselves the subject of a health care fraud investigation. The feds do not take allegations of health care fraud lightly. Allegations will likely result in an investigation. If the investigation is successful, the accused can face stiff financial penalties and potential imprisonment. As such, those facing such accusations or who find themselves the subject of an investigation are wise to act to protect their interests.

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