DNA cancer screening tables are a medicare scam

[AcemanX007]

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.

 

[sheilaja]

What bulletin? From CMS???

 

[myinsurebiz]

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.

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.

 

[Northeast Agent]

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.

 

[djones745]

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...

 

[myinsurebiz]

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...

AFFA is a joke.

 

[LostDollar]

I’m surprised Gordon Marketing isn’t chiming in on this thread as they are pitching this to agents...

See Steve Savant's new post.
(Probably wise comments are locked on his postings.)

 

[goillini52]

See Steve Savant's new post.
(Probably wise comments are locked on his postings.)

Was it just me LD, or did you see some sparks between those 2?

 

[vic120]

I’m surprised Gordon Marketing isn’t chiming in on this thread as they are pitching this to agents...

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

 

[Northeast Agent]

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.