DNA cancer screening tables are a medicare scam

[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.

https://www.cms.gov/outreach-and-ed...edicare_fanda_physicians_factsheet_905645.pdf

If doctors can't receive kickbacks why would you think you'd be able to receive a kickback?

Anti-Kickback Statute (AKS) The AKS makes it a crime to knowingly and willfully offer, pay, solicit, or receive any remuneration directly or indirectly to induce or reward referrals of items or services reimbursable by a Federal health care program. When a provider offers, pays, solicits, or receives unlawful remuneration, the provider violates the AKS. NOTE: Remuneration includes anything of value, such as cash, free rent, expensive hotel stays and meals, and excessive compensation for medical directorships or consultancies.

Criminal Health Care Fraud Statute The Criminal Health Care Fraud Statute prohibits knowingly and willfully executing, or attempting to execute, a scheme or artifice in connection with the delivery of or payment for health care benefits, items, or services to either: ● Defraud any health care benefit program, or ● Obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the control of, any health care benefit program Penalties for violating the Criminal Health Care Fraud Statute may include fines, imprisonment, or both.

 

[senior-advisor-indiana]

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.

I would also be curious to know. I doubt most agents write 50 supps per year and most don't stay in the business more than a year or two. I know when I worked for captive companies there were a lot of non producers...

 

[sshafran]

I would also be curious to know. I doubt most agents write 50 supps per year and most don't stay in the business more than a year or two. I know when I worked for captive companies there were a lot of non producers...

I don't blame them. My first few years I worked another job... probably wrote 50-60 per year. My other job kept me afloat. It would have been easy to say, "forget this, it's too slow."

 

[sheilaja]

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.

 

[sheilaja]

I am very curious about an actual CARRIER terminating people? Can you elaborate on the specifics here?

 

[Andrew Makoid]

I can't say what carrier but they have emailed all agents appointed sharing this info. and warning them. They are specifically talking about referring people to those "screening" fairs where they collect a cheek swab and the beneficiaries info. that "DNA test" is not neccessary and medicare doesn't pay for it.

 

[sheilaja]

I received an email from UHC warning of potential scam, but the link inside Thier email does not work, and I contacted them regarding more info,. They have removed their link and have postponed this currently....hmmm ?? Why did they do that

 

[Andrew Makoid]

Perhaps they are waiting for clarification from CMS like myself.

 

[somarco]

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.

I would agree to all your points.

Most give up and probably don't get to 50 lives.

Paying living expenses AND marketing costs to get to 300 is tough. I usually figure 3 to 5 years. Can be quicker if you put a lot of $$$ in lead gen. (I didn't and still put almost $0 in).

SAI has been at this about 10 years. He is still thinking he will crack 100 lives before the next decade.

 

[rousemark]

I would agree to all your points.

Most give up and probably don't get to 50 lives.

Paying living expenses AND marketing costs to get to 300 is tough. I usually figure 3 to 5 years. Can be quicker if you put a lot of $$$ in lead gen. (I didn't and still put almost $0 in).

SAI has been at this about 10 years. He is still thinking he will crack 100 lives before the next decade.

Back in the "good ol' days" I was personally writing around 80 per year knocking doors and calling on referrals.. Back then, I did not know of anyone that was using direct mail for med supp and only one or two that using it for FE.. My, how times have changed..