- 30,537
I'm sure you can figure something out.
DNA cancer screening tables are a medicare scam
- Thread starter AcemanX007
- Start date
Arroyo Aaron
New Member
- 12
I think they will limit the amount of companies that are able to provide this service...by making the compliance harder...maybe it will stop all together but it started 2 yrs ago, just more companies are finding out about it...
- 6,024
Imagine that . . .
Well, UHC has sent it out again!
Update – Help Consumers Avoid Genetic Testing Fraud
Over the last couple of weeks, UnitedHealthcare has received questions from agents like you about genetic testing companies offering to pay agents to promote genetic testing services to Medicare beneficiaries. You are an advocate for your members and consumers, and we want to provide you with information that helps protect consumers from potential health care fraud. We also want to bring awareness of our policies for when you are dealing with organizations with which UnitedHealthcare does not have an affiliation.
Here is what you need to know
UnitedHealthcare agents may not promote genetic testing services to UnitedHealthcare members and/or consumers. UnitedHealthcare is prohibiting this activity for a number of reasons:
If we learn of any activities by agents using UnitedHealthcare information or targeting of UnitedHealthcare members or consumers for the purpose of promoting genetic testing, we will take all appropriate action, which may include terminating an agent's producer agreement.
Questions
If you have questions or would like to report concerns about offers received to work with genetic testing companies, contact the Compliance mailbox at [email protected].
Thank you for your business! We strive to provide unmatched value and a distinctive experience to you and our members.
Update – Help Consumers Avoid Genetic Testing Fraud
Over the last couple of weeks, UnitedHealthcare has received questions from agents like you about genetic testing companies offering to pay agents to promote genetic testing services to Medicare beneficiaries. You are an advocate for your members and consumers, and we want to provide you with information that helps protect consumers from potential health care fraud. We also want to bring awareness of our policies for when you are dealing with organizations with which UnitedHealthcare does not have an affiliation.
Here is what you need to know
UnitedHealthcare agents may not promote genetic testing services to UnitedHealthcare members and/or consumers. UnitedHealthcare is prohibiting this activity for a number of reasons:
- CMS Marketing Rules - CMS prohibits health screenings, like genetic testing, at marketing events because they can be perceived as cherry picking.
- UnitedHealthcare Producer Agreement/Policies - Under the UnitedHealthcare producer agreement, sales agents may not:
- Act on behalf of UnitedHealthcare in promoting genetic testing services to members or consumers
- Use our member PHI or UnitedHealthcare lead information to promote genetic testing services
- Make representations about whether particular testing is covered by UnitedHealthcare
- Steer UnitedHealthcare members to obtain tests through particular providers/labs based on financial interests
- Anti-Kickback Law - Based on the information provided to UnitedHealthcare to date, we are concerned that some genetic testing companies appear to be paying agents to make a referral for medical testing that will be paid for by Medicare. These kinds of arrangements may implicate the Federal Anti-Kickback Statute.
If we learn of any activities by agents using UnitedHealthcare information or targeting of UnitedHealthcare members or consumers for the purpose of promoting genetic testing, we will take all appropriate action, which may include terminating an agent's producer agreement.
Questions
If you have questions or would like to report concerns about offers received to work with genetic testing companies, contact the Compliance mailbox at [email protected].
Thank you for your business! We strive to provide unmatched value and a distinctive experience to you and our members.
- 2,133
Well, UHC has sent it out again!
Update – Help Consumers Avoid Genetic Testing Fraud
Well, MrMedicare101, what have you got to say about UHC's links that were "taken down" and "broken" now? Or are you still hanging on by a thread?
I wonder if Gordon Marketing will finally take down their sponsored ads on here now?
Update – Help Consumers Avoid Genetic Testing Fraud
Well, MrMedicare101, what have you got to say about UHC's links that were "taken down" and "broken" now? Or are you still hanging on by a thread?
I wonder if Gordon Marketing will finally take down their sponsored ads on here now?
I'm assuming Gordon has a UHC contract. Man, if that gets pulled, imagine the hundreds of thousands in lost commissions.
Wow.
I would hope that UHC would give some sort of opportunity to turn the ship and cease the dna gig before terminating.
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- 2,133
I think the $hit is about to start hitting the fan in all directions...
But maybe not with UHC, as supposedly not "all" carriers participated. Humana told me they didn't, at a training several weeks ago. No idea about Aetna?
Grab the popcorn and sit back...Fireworks are coming.
But maybe not with UHC, as supposedly not "all" carriers participated. Humana told me they didn't, at a training several weeks ago. No idea about Aetna?
Grab the popcorn and sit back...Fireworks are coming.
Arroyo Aaron
New Member
- 12
Another thought as to what may be happening, many companies are finding out that their agents can make more money doing the screenings versus selling a policy. And if I was a company owner I wouldn't want my agents marketing to my customers for another company. At some point I would have to make decision on residual income or a one time payment... Especially dealing in a market where I have no control...At this point am a Giant in the insurance market I have influence across the lines except in Medicare...But I can pressure them to tighten up the loop holes...
I personally don't see this as fraud as long as the reps are presenting it correctly...But you know they publicly screen all the time for certain things and you never hear such fuss maybe because Medicare is involved and not your regular HMO or PPO...This should be something the insurance companies embrace but most people in the qualification age range don't have them as a insurer anyway...it's about the money and it's political...
I personally don't see this as fraud as long as the reps are presenting it correctly...But you know they publicly screen all the time for certain things and you never hear such fuss maybe because Medicare is involved and not your regular HMO or PPO...This should be something the insurance companies embrace but most people in the qualification age range don't have them as a insurer anyway...it's about the money and it's political...
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