DNA cancer screening tables are a medicare scam

[senior-advisor-indiana]

money money money. So 10,000 agents with an average customer base of 300 medicare beneficiaries each get their customers to provide their personal medicare and medical information to a testing lab. Lots of government cash floating around.

So the average book of Med Supps is around 300 clients?

 

[somarco]

So the average book of Med Supps is around 300 clients?

Could be.

There are agents in Indiana with only 1 client. That brings the average down a bit.

 

[rousemark]

Could be.

There are agents in Indiana with only 1 client. That brings the average down a bit.

Thought Rick replaced that one with a phone sale...

 

[somarco]

Thought Rick replaced that one with a phone sale...

That really doesn't have that much of an impact. Averaging less than 1 client out of the MILLIONS of agents out there won't matter.

I don't think it was the usual phone sale. I believe the person was a referral from her current agent.

 

[LostDollar]

So the average book of Med Supps is around 300 clients?

Well ... you caught me. It's actually only 298 but since my iq is not as high as that of another regular poster, I had to round the number to make the math easier.

 

[Andrew Makoid]

The document stated as from CMS at the start of this thread is not from CMS it is from ConnectiCare which is an insurance company that stuck a CMS logo on it. I work closely with many Medicare carriers and no one has been actually able to produce anything from CMS about this. I think this is turning into much ado about nothing. If you actually can provide a link to anything directly produced by CMS please share it with the source link. I have spent a while researching this and really haven't seen anything in the real world about this being a scam or any warnings or directions from CMS regarding this other than they explicitly say they will not pay if the screen is not medically necessary and prescribed by a board certified doctor. I saw that a company in CA was just sentenced for doing this and suspect that it was this news that started the entire knee jerk reaction to this.

 

[somarco]

Palmetto GBA - Railroad Beneficiaries - Medicare Scams Surround Unnecessary Genetic Testing

Coverage and Payment for Genetic Laboratory Tests (OEI-07-11-00011) 06-12-2012

Criminal Enforcement Actions | Medicare and Medicaid Fraud | Office of Inspector General | U.S. Department of Health and Human Services

Medicare Fraud Alerts | California Health Advocates

 

[Andrew Makoid]

So not one of those links actually gives anything from CMS directly about these scams. I spent the morning on the phone with CMS and they truly did not put anything out about these at this point. Other than releasing information about the newly approved test for cancer. Their advanced resolution center has said they will call me back within seven days and provide a fact sheet for me. I will post that information when it becomes available.

 

[goillini52]

So not one of those links actually gives anything from CMS directly about these scams. I spent the morning on the phone with CMS and they truly did not put anything out about these at this point. Other than releasing information about the newly approved test for cancer. Their advanced resolution center has said they will call me back within seven days and provide a fact sheet for me. I will post that information when it becomes available.

Do you really think they'll send you anything?

 

[Andrew Makoid]

I am not holding my breath. It took about 45 mins to just get through to someone who knew what I was talking about they then escalated the call to the "Advanced Resolution Department" whatever that is. At least I was able to confirm that they have not put out any warnings about this "scam" officially through CMS news or press releases.