DNA cancer screening tables are a medicare scam

[LostDollar]

I didn't not. I was trying to remind you that every new idea involving Medicare is never received with open arms. Mainly due to regulations. But at the same time be more open to new ideas, not every thing out there is a scam. Medicare is trying o find ways to save lives and money. Hence I talked about diabetics shoe as an example.

The "scheme" being discussed in this thread appears to be a collusive effort to misuse the "possible eligibility" of Medicare beneficiaries for a medical service to defraud the Medicare system to the financial benefit of the providers of the supposedly beneficial medical service.

 

[LostDollar]

There is a 2008 law that presumably forbids an insurer or employer from discriminating against you an the basis of the genetic testing.. However,we all know how that tends to out..

Thanks for the post. I was unaware that there was any effort to prevent misuses of this type of information.

 

[LostDollar]

When MA was introduced it was received with the same red flag. Look at the numbers? it is becoming more popular every year.

Diabetic shoe is covered by health Insurance. But some people will spend money because they are not aware they can get them at no cost.

Povidiving diabetic shoe to patients is a preventive movement to prevent amputation which cost the government more money for disability and the cost of maintenance verse a pair of shoe.

Genetic cancer screening provides DNA, the genotype of a particular cancer. This is meant to be preventive. Some cancer are hereditary such as prostate, breast cancer etc.

When genetic cancer of a family history is already identified it is detected early and removed before it mutates to stage 4. Chemo and all medical cost for a cancer patient is very expensive one can spend easy $10,000.

Look at it as a positive program that will cost the patient less money. Medicare is ready to spend anything less than $10000 to treat one patient for chemo.

If a person's father, uncle and grandfather have all had prostate cancer, or a person's mother, aunt and grandmother have all had breast cancer, it does not take a $1K-$2K genetic test to suggest that those people should be involved in regular testing such as PSA tests or mammograms.

 

[goillini52]

I didn't not.

I like your use of a double negative. I think I'm going to start doing that. I didn't not do it. It wasn't not me. I don't not scratch in public(when anybody's looking).

 

[myinsurebiz]

The "scheme" being discussed in this thread appears to be a collusive effort to misuse the "possible eligibility" of Medicare beneficiaries for a medical service to defraud the Medicare system to the financial benefit of the providers of the supposedly beneficial medical service.

Not a "scheme". At the moment, it is an allowed marketing opportunity for those that want to help provide information that may prevent / cure occurrences of cancer in someone's life / family.

 

[myinsurebiz]

My upline tells me its set up so you call into a teledoc that does a "needs assessment" and then orders the test. It does sound a little fishy. My guess is it will last a few months, not even a year before they change the rules.

More happens in the forefront before consulting the licensed Physician.

I think it will hang around a bit. CMS is slow to make change. Each of the 13 Medicare Regions have their own opinion of these tests already.

 

[myinsurebiz]

One genetic test with risk is worth $700-900 depending on which post you see.

Quick "easy money."

But it's a gray area... likely, not viable long-term.

I'll let some agents pursue this and I'll keep building my Medicare book. Each new client is worth $1,500+ LTV.

Double the income, no risk of fraud.

It's really a no-brained for an agent which path to go all in on.

Some tests pay $2,000 or more . . .

 

[myinsurebiz]

If a person's father, uncle and grandfather have all had prostate cancer, or a person's mother, aunt and grandmother have all had breast cancer, it does not take a $1K-$2K genetic test to suggest that those people should be involved in regular testing such as PSA tests or mammograms.

How do you know if it takes " a $1K-$2K genetic test to suggest that those people should be involved in regular testing such as PSA tests or mammograms. " ?

Are you now a Doctor in addition to a wannabe Insurance Agent?

 

[sshafran]

in addition to a wannabe Insurance Agent?

Takes one to know one...

 

[NormMitchell]

Don't be blinded by the potential of easy money. This opportunity was documented to the State Health Insurance Assistance Program (SHIP -https://acl.gov/programs/connecting-people-services/state-health-insurance-assistance-program-ship) who confirmed in an Email that it was considered fraud/scam and they forwarded the information to the Inspector General's Office for further review, investigation, and processing. Where the problem arises is two-fold, 1st the referral to a physician outside the Medicare recipients primary physician (yeah I know myinsurebiz you say you can't find anything which states that's illegal but pull your head out of your ass and think about it a moment in relation to this next part) and 2nd: The Anti Kickback Statute (AKS) is a criminal law that prohibits the knowing and willful payment of "remuneration" [[[[[[to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs (e.g., drugs, supplies, or health care services for Medicare or Medicaid patients).]]]]]] Remuneration includes anything of value and can take many forms besides cash, such as free rent, expensive hotel stays and meals, and excessive compensation for medical directorships or consultancies. In some industries, it is acceptable to reward those who refer business to you. [[[[[[[However, in the Federal health care programs, paying for referrals is a crime.]]]]] The statute covers the payers of kickbacks-those who offer or pay remuneration- as well as the recipients of kickbacks-those who solicit or receive remuneration. Each party's intent is a key element of their liability under the AKS. (This is the link: https://prd-medweb-cdn.s3.amazonaws.com/documents/DCCI/files/Anti-Kickback Statute.pdf). Now I don't know what they are calling the payment you receive from whoever is paying you (referring doctor, labs doing testing, your upline, whoever), but it is nothing more than a KICKBACK paid to you for referring that Medicare recipient. It's really not rocket science if you step back and take a focused look at it.