DNA cancer screening tables are a medicare scam

[somarco]

Palmetto is a Medicare TPA (MAC).

OIG investigates, among other things, Medicare fraud.

CHA is a well respected site by most folks who know anything about Medicare.

I can easily see how some agents may think they know more about potential fraud than any of these rascals.

 

[myinsurebiz]

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.

Bahahahahahaha . . .

 

[goillini52]

Bahahahahahaha . . .

Damn it Lamb Chops. You need to man up!!! NO MORE PINK OR LAVENDER SHEEP SOUNDS!!!

If I didn't know better, I'd think you were a gay sheep.

 

[Andrew Makoid]

I am not saying this is not fraud I am saying that CMS has not issued any documents spelling it out. All they have done is to confirm what we all already know. That these have to be medically necessary and ordered by a board-certified doctor not necessarily the beneficiaries primary either. If you can actually provide anything from the organization that governs Medicare then please share it. We are all aware that some places are running scams on Medicare beneficiaries.

 

[myinsurebiz]

I am not saying this is not fraud I am saying that CMS has not issued any documents spelling it out. All they have done is to confirm what we all already know. That these have to be medically necessary and ordered by a board-certified doctor not necessarily the beneficiaries primary either. If you can actually provide anything from the organization that governs Medicare then please share it. We are all aware that some places are running scams on Medicare beneficiaries.

Don't need anything from CMS to prove anything - this concept most def violates the Anti-Kickback statutes - in my opinion . . .

I'm not touching it with a 10' pole.

 

[goillini52]

I'm not touching it with a 10' pole.

Nahhhh, I'd better just leave it alone.

 

[Andrew Makoid]

I am with you on that myinsurebiz. I am advising all my agents the same thing. Why even live in the grey area for a few dollars when it could potentially ruin your entire career? A major carrier has termed several agents for this already this month.

 

[Andrew Makoid]

Sorry the reason I am wanting this information directly from CMS is that I deal with a lot of insurance agents and am responsible for getting accurate information out to them. So I generally don't send anything unless it comes from a carrier or CMS directly. I want to share facts with my agents not opinions. I have been advising agents to not take part in anything until CMS actually says whether this is ok or not and how to go about whatever it is compliantly.

 

[sshafran]

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

Curious what the average agent book is... My guess closer to 150...

300 = approx $80,000 yearly revenue. I would have to think most agents quit before that. Not that getting to 300 is hard... but paying bills and marketing on the way to 300 is hard.

 

[NormMitchell]

Sorry the reason I am wanting this information directly from CMS is that I deal with a lot of insurance agents and am responsible for getting accurate information out to them. So I generally don't send anything unless it comes from a carrier or CMS directly. I want to share facts with my agents not opinions. I have been advising agents to not take part in anything until CMS actually says whether this is ok or not and how to go about whatever it is compliantly.

The problem is not with the TESTS! Sure a doctor can refer them for the testing if after talking with the Medicare Recipient the doctor feels it is justified (of course they would like it to be their personal physician, not someone who is in the pipeline or with the lab). The problem is that YOU (those of you who are participating in this) ARE RECEIVING A KICKBACK! And CMS has put out lots of information about the illegality of receiving a kickback. Just look up the anti-kickback law.