DNA cancer screening tables are a medicare scam

Dec 17, 2018

  1. AcemanX007
    Offline

    AcemanX007 Expert

    Posts:
    48
    Likes Received:
    14
    I’ve taken a more proactive step and started warning senior centers and towers of this, showing them the bulletin from CMS. After all the doors are shut, hopefully people will come to their senses and stop pushing this. Leave the medical testing to the doctors.
     
  2. sheilaja
    Offline

    sheilaja New Member

    Posts:
    8
    Likes Received:
    3
    State:
    Missouri
    What bulletin? From CMS???
     
  3. myinsurebiz
    Offline

    myinsurebiz Guru

    Posts:
    4,500
    Likes Received:
    616
    State:
    Hawaii
    CMS hasn't released an official memo or opinion on this concept yet . . .

    Some organizations are applying the CMS logo and phone # on some of their flyers - but, CMS so far is silent.
     
  4. Northeast Agent
    Offline

    Northeast Agent Guru

    Posts:
    600
    Likes Received:
    347
    State:
    Pennsylvania
    Humana's the latest carrier to speak out via email yesterday:

    2019 Compliance Communication - Genetic Testing

    It has come to our attention that agents are being recruited by third parties to conduct outreach to Medicare beneficiaries to promote and complete oral swabs for genetic testing in exchange for compensation. Programs such as these may create opportunities for fraud, waste, and abuse that can negatively impact the beneficiary, the agent, and the Plan Sponsor.

    What Does This Mean For Agents

    We want to remind agents of their responsibility to follow all state and federal laws as well as the CMS Medicare Communication and Marketing Guidelines. Agents should not engage in any activities unless they are able to confirm their participation will be compliant with any applicable laws, Humana policies and their Humana contract.*

    Compliance Reminders:
    • The federal Anti-Kickback Statute (“AKS”) prohibits any person from knowingly and willfully exchanging anything of value in return for a referral for items or services covered by a federal health care program (42 U.S.C. § 1320a-7b). Federal health care programs include, but are not limited to, Medicare and Medicaid. Penalties for violating the AKS include imprisonment, criminal fines, civil monetary penalties and exclusion from federal health care programs.
    • Per the Medicare Communications and Marketing Guidelines (MCMG), agents may not participate in sales/marketing events where there are health screening or other similar activities that could give the impression of “cherry picking”.
    • Failure to comply with state and federal laws or the MCMG may subject agents to corrective actions that could lead up to and include termination of their employment/ contract with Humana.
    *Humana will not advise on the legality of any activities conducted by third party organizations.
     
  5. djones745
    Offline

    djones745 New Member

    Posts:
    11
    Likes Received:
    1
    State:
    Illinois
    Aetna came out with a similar communication yesterday. Looks like the MA carriers will be policing this faster than CMS.

    Today I received an email from AFFA outlining their w-2 employee workaround b.s. Definitely not worth risking my book of business over a quick buck or two...
     
  6. myinsurebiz
    Offline

    myinsurebiz Guru

    Posts:
    4,500
    Likes Received:
    616
    State:
    Hawaii
    AFFA is a joke.
     
  7. LostDollar
    Offline

    LostDollar Guru

    Posts:
    2,740
    Likes Received:
    532
    State:
    Kansas
    See Steve Savant's new post.
    (Probably wise comments are locked on his postings.)
     
  8. goillini52
    Offline

    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

    Posts:
    19,216
    Likes Received:
    5,463
    State:
    Illinois
    Was it just me LD, or did you see some sparks between those 2? :)
     
  9. vic120
    Offline

    vic120 Guru

    Posts:
    2,875
    Likes Received:
    651
    State:
    Tennessee
    Yes they have been vocal and see there advertising on this site for DNA cancer Screening even now

    Would love to see how they address these carrier warnings
     
    vic120, Mar 19, 2019
  10. Northeast Agent
    Offline

    Northeast Agent Guru

    Posts:
    600
    Likes Received:
    347
    State:
    Pennsylvania
    I just watched the video. Interesting how the comments are disabled for this one.

    Do they have an exclusive agreement with CMS and a lab, do you think? Unless they are just finding people with Original Medicare and a Med Supp, as the MA carriers kicked it to the curb.
     
Loading...