The Department of Health and Human Services Office of Inspector General, with our law enforcement partners, announced in September 2019 our efforts to target genetic testing fraud schemes nationwide. The takedown resulted in charges against 35 individuals for their alleged participation in healthcare fraud schemes involving $2.1 billion in losses. In the alleged scheme, recruiters (aka marketers) get a Medicare beneficiary to take a genetic test.
The recruiter then gets a doctor to sign off on the genetic test so a lab will process the test. The recruiter pays the doctor a kickback in exchange for ordering the test. Then the lab processes the test and bills Medicare. Medicare reimburses the lab for the test and the lab shares the proceeds of that payment with the recruiter. This enforcement action shows the positive impact OIG is making to fight fraud and protect HHS programs and beneficiaries.
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Last updated April 13, 2021