DNA cancer screening tables are a medicare scam

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.
They are NOT allowed to put a CMS logo on ANYTHING! must be from CMS and have a code on it, looks like they have committed fraud!!!!
 
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
There are other organization doing this that are NOT doing it right and this is addressing them.
 
Our agency has recently been introduced to this concept and just as many of you, we've had our concerns as well. However we are moving forward with the process, a broker from our upline was approached by the lab and she's been to the facility to meet with the staff.

Not everyone will qualify, the test will be administered by a genetics lab and not all plans are accepted. Original Medicare, Medicaid, PPO plans with UHC, Aetna, Humana, and Cigna will be accepted, not any HMO plans and no one under the age of 18.

The prospect must have 3 different people in the family tree (mother, father, sister, aunt, uncle, grandfather) with cancer and it has to be different types (lung, prostate, ovarian). However if the client themselves have had or has cancer then it's an automatic green light. It's a fairly new process for the lab so contracting has been slow and the commission can vary from lab to lab and your downline structure. I know I lot of FMO's are paying agents $300 across the board but we've chosen to pay more. Plus give you the opportunity to have a downline.

The opportunity is also open to non agents which would require an AML certificate and HIPPA. As a licensed agent you already have these certs due to AHIP, E&O and AML if you write life insurance.

The first payment takes 2 months to receive then after you are set up it comes faster. Our upline has submitted 12 swab kits, and I've done 4. The kits cost $35 but the lab is selling them to us for $10. Not sure if that's across the board, but this is how we are working things with our lab. Once I get paid I'll be sure to post an update and let you guys know. Carriers don't like this because it pays more than a MAPD plan and agents literally will stop producing Medicare plans and turn to this so I can see why UHC would be skeptical. Good luck guys I'll keep you informed.
I know who your speaking of, this is the one I'm going with also!
 
AmberBurd:

Oh & The inspector was called and reported to UHC and they were told to disable the links.


Inspector of what company? This is insanity.

Not everyone will qualify, the test will be administered by a genetics lab and not all plans are accepted. Original Medicare, Medicaid, PPO plans with UHC, Aetna, Humana, and Cigna will be accepted, not any HMO plans and no one under the age of 18.

I know who your speaking of, this is the one I'm going with also!


As UHC has stated they aren't part of this, why are you going with this company??? You must be a new agent.
 
AmberBurd:

Oh & The inspector was called and reported to UHC and they were told to disable the links.


Inspector of what company? This is insanity.

Not everyone will qualify, the test will be administered by a genetics lab and not all plans are accepted. Original Medicare, Medicaid, PPO plans with UHC, Aetna, Humana, and Cigna will be accepted, not any HMO plans and no one under the age of 18.

I know who your speaking of, this is the one I'm going with also!


As UHC has stated they aren't part of this, why are you going with this company??? You must be a new agent.
Link to UHC site for Genetic Testing.
https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/genetic-testing-hereditary-breast-ovarian-cancer-syndrome.pdf
 
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