Genetic Testing Scheme Alert

An alert to providers regarding a genetic testing scheme that currently is happening in many states, including Missouri.

The Department of Social Services (DSS) wants to alert providers to a genetic testing scheme that is currently happening in many states, including Missouri. 

On June 3, 2019, the U.S. Department of Health and Human Services (DHHS) Office of Inspector General (OIG) issued an alert regarding scammers offering individuals cheek swabs for genetic testing to obtain their Medicare or Medicaid information for identity theft or fraudulent billing purposes. Fraudsters are targeting beneficiaries through door-to-door visits, booths at public events, health fairs, and telemarketing calls.

DSS has received reports that genetic testing marketers have been contacting Missouri residents throughout the state. They might put on some type of game like bingo with prizes or food to get residents to come to them. Sometimes announcements are made to all senior housing residents over a building intercom system. They typically try to determine if the individual has Medicare or Medicaid coverage. They may be dressed in scrubs or white coats to give the appearance they are a healthcare professional. In some cases, they may indicate they represent a medical research facility.

They typically have a short questionnaire and ask whether any of the individual’s relatives have had cancer or other diseases. They indicate a genetic test can be conducted to determine if the individuals already has a disease, or if they are susceptible to acquiring the condition. In some cases, they indicate the test will tell whether the combination of prescription and over the counter medications the individual is taking are having an undesired interactions or adverse effects on their metabolism.

If the individual agrees to be tested, the representative obtains their Medicare or Medicaid numbers and uses a swab to take a saliva sample from inside their mouth. The individual might be asked to sign the questionnaire. They are typically told the test results will be sent to them in several weeks, usually somewhere between four and eight weeks. The individuals might not receive the results of a lab test later.

MO HealthNet participants who have been solicited by a genetic testing marketer to provide a saliva sample using a cheek swab, or have already provided one, please report it to the Missouri Medicaid Audit & Compliance (MMAC) by email or call the MMAC Fraud Hotline at 573-751-3285.

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