Seniors: Watch out for genetic testing fraud

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PIERRE, S.D. (KELO) — Officials are warning a national fraud scheme has come to South Dakota.

Essentially what happens is people are being offered “free” DNA testing or cancer screenings. All they have to do is give their Medicare number.

The South Dakota Department of Health said they have their first report in the state.

Caitlin Christensen is the director of SHIINE (Senior Health and Insurance Information). She said a salesperson visited the fraud victim.

“In this specific instance, the salesperson had visited twice before and then had two more set up that we were able to get canceled,” Christensen said.

Basically what happens is the salesperson will go to a health fair, senior center, show up at someone’s door or cold call. They tell the person that Medicare will pay for genetic testing.

Then, they’re either do the genetic testing swabs right there or that personal health information and then mail a kit.

“The problem with this really is that unless these tests are ordered by a doctor and they meet the medical necessity requirements that Medicare has set in place they won’t be paid for by the Medicare system,” Christensen said. “So the beneficiaries end up owing money on these huge bills when they had been told previously that it would be paid for.”

Christensen said the case in South Dakota was to allow people to see how their body metabolizes prescriptions.

“Because if your body isn’t metabolizing those drugs properly then you’re wasting your money,” Christensen said.

There are legitimate tests for that and doctors can request them, or there are non-clinical options like 23andMe for ancestry or limited health tests. Those aren’t covered by insurance.

The big piece of advice is: never give out your Medicare number, unless it’s to your doctor’s office.

The U.S. Department of Health and Human Services has this information to Medicare beneficiaries:

  • If a genetic testing kit is mailed to you, don’t accept it unless it was ordered by your physician. Refuse the delivery or return it to the sender. Keep a record of the sender’s name and the date you returned the items.
  • Be suspicious of anyone who offers you “free” genetic testing and then requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes.
  • A physician that you know and trust should assess your condition and approve any requests for genetic testing.
  • Medicare beneficiaries should be cautious of unsolicited requests for their Medicare numbers. If anyone other than your physician’s office requests your Medicare information, do not provide it.

In South Dakota, if you believe fraud is happening Christensen says to call the South Dakota Attorney General’s Office, Division of Consumer Protection at 1-800-300-1986 or by emailing them.

She also said to contact your local SHIINE office for any Medicare questions.

Eastern South Dakota: Phone: 605.333.3314 or 800.536.8197

Central South Dakota:
Phone: 605.494.0219 or 877.331.4834

Western South Dakota:
Phone: 605.342.8635 or 877.286.9072

How to find the right type of genetic testing

Trying to figure out how or why to do genetic testing can be an important decision in a person’s life.

There are a few types of genetic tests. The most commonly heard about are called “direct-to-consumer tests. These are the 23andMe, Ancestry, etc.

“Because there is currently little regulation of direct-to-consumer genetic testing services, it is important to assess the quality of available services before pursuing any testing.”

National Insitutes of Health

There are several challenges with the direct-to-consumer tests. One of the biggest is the lack of support after the tests come back. Often there is no genetic counseling or follow-up.

It’s important to know that insurance and Medicare often don’t cover these direct-to-consumer tests.