DNA cancer screening tables are a medicare scam

Dec 17, 2018

  1. LostDollar
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    LostDollar Guru

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    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.
     
  2. LostDollar
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    LostDollar Guru

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

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    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.
     
  4. goillini52
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    goillini52 KeepAmericaGreat...Eat Bacon & BUILD THAT WALL!!!

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    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). :biggrin:
     
  5. myinsurebiz
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    myinsurebiz Guru

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    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.
     
  6. myinsurebiz
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    myinsurebiz Guru

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    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.
     
  7. myinsurebiz
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    myinsurebiz Guru

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    Some tests pay $2,000 or more . . .
     
  8. myinsurebiz
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    myinsurebiz Guru

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    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?
     
  9. sshafran
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    sshafran Guru

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    Takes one to know one...
     
    Last edited: Feb 11, 2019
  10. NormMitchell
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    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.
     
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