Capitalizing on the growing popularity of genetic testing, scammers are persuading seniors to hand over their DNA, not knowing it may lead to identity theft and Medicare fraud.
The 86-year-old woman in rural Utah doesn’t usually answer solicitations from strangers, she said, but the young couple who knocked on her front door seemed so nice. Before long, she had handed over her Medicare and Social Security numbers — and allowed them to swab her cheek to collect her DNA.
She is among scores of older Americans who have been targeted in a scam that uses DNA tests to defraud Medicare or steal personal information. Fraudsters find their victims across the country through cold calls, door knocking, email, Facebook ads and Craigslist. They also troll low-income housing complexes, senior centers, health fairs and antique shops. Sometimes they offer ice cream, pizza or $100 gift cards. Some callers claim to work for Medicare, according to a fraud alert issued July 19 by the Federal Trade Commission.
The woman in Utah said she didn’t know the purpose of the DNA test she submitted to this month — “I’m too old to remember” — but the visit troubled her for several nights, she said.
“I’d lie awake thinking about it, saying, ‘You fool, you shouldn’t have done that.’” (She spoke on the condition of anonymity for fear of being targeted by other scams.)
In interviews with Kaiser Health News, seniors around the country reported feeling betrayed, exposed and confused.
Capitalizing on the growing popularity of genetic testing — and fears of terminal illness — scammers are persuading seniors to take two types of genetic screenings that are covered by Medicare Part B, according to experts familiar with the schemes. The tests aim to detect their risk for cancer or medication side effects.
The scammers bill Medicare for the tests. The patients, who might never receive any results, typically pay nothing. But they risk compromising personal information and family medical history. And taxpayers foot the bill for tests that may be unnecessary or inappropriate.
Scammers can really cash in: Medicare pays an average of $6,000 to $9,000 for these tests, and sometimes as much as $25,000, according to the Office of Inspector General at the Department of Health and Human Services.
DNA test scams appear to be ramping up: Complaints to the inspector general fraud hotline have poured in at rates as high as 50 per week, according to Sheila Davis, an OIG spokeswoman. That’s compared with one or two complaints a week at the same time last year, she said.
The inspector general issued a fraud alert in June, urging seniors to refuse unsolicited requests for their Medicare numbers and take DNA tests only with the approval of a doctor they know and trust. By Medicare rules, DNA tests must be medically necessary and approved by a physician who is treating the patient.
In cases that have gone to court, scammers were accused of breaking those rules by paying kickbacks to doctors who agreed to order DNA tests for patients without ever treating them. The front-line recruiters who solicit the tests might work directly for a lab, or as independent contractors who divide revenue with a laboratory in exchange for bringing in extra business.
Some solicitors try to scare seniors into cooperating, said Shimon Richmond, an assistant inspector general for investigations. They warn seniors that they could be vulnerable to heart attacks, stroke, cancer or even suicide if they do not take the DNA tests.
“That’s a pretty egregious form of patient manipulation and emotional abuse,” Richmond said.
Richmond said the two tests involved in the scams are: CGx, which tests for genetic predisposition to cancer, and PGx, a pharmacogenomic test for genetic mutations that affect how the body handles certain medications. They’re part of a new frontier of preventive genetic health.
In New Jersey, three people were sent to federal prison in May for a scheme that used a purported nonprofit called Good Samaritans of America to persuade hundreds of seniors to take DNA tests. The co-conspirators raked in $100,000 in commissions from labs that ran the tests, according to the government.
“This is a gold-rush area for folks. It’s leading to a big response by the government,” said Assistant U.S. Attorney Bernard Cooney, a prosecutor in the case.
This month, a Florida doctor was charged in federal court for his role in an alleged fraud scheme to order DNA tests for patients in Oklahoma, Arizona, Tennessee and Mississippi. Patients were recruited through Facebook ads offering $100 gift cards, according to court records. The doctor allegedly confessed that he was being paid $5,000 per month to approve these tests, even though he never spoke to any of the patients involved.
Some labs accused of billing Medicare for unnecessary genetic tests — including Millennium Health and Companion DX Reference Lab — agreed to repay the government but declared bankruptcy before doing so, leaving taxpayers on the hook.
Meanwhile, older Americans are encountering sales pitches that leave them feeling deceived.
In Weslaco, Texas, Will Dickey, a 71-year-old retired police detective, submitted to a DNA test at a health fair in February.
“I have a bunch of cancer in my family,” he recalled thinking, so “it’d help if I had an idea of what genes I had in me.” Three weeks later, he saw the same salesperson rounding up business at his RV park, where his wife and several neighbors got their cheeks swabbed. Dickey, who spent 10 years working with DNA tests in a police crime lab, said he was surprised at the cost: A lab in Mississippi charged Medicare $10,410 for his tests.