Genetic Testing for Cancer Fraud Scheme - DoctorsManagement Genetic Testing for Cancer Fraud Scheme - DoctorsManagement

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THE COMPLIANCE GUY BLOG

Genetic Testing for Cancer Fraud Scheme

May 5, 2021

by Sean Weiss, Partner & VP of Compliance

For those of you working in genetic testing and oncology services, genetic testing for cancer has become a huge audit target of Medicare! Recently, 3 Florida men were charged with scheming to defraud Medicare. They were charged with inducing beneficiaries to accept cancer genetic tests regardless of whether the test was medically necessary or not!

As part of the scheme, they offered and paid illegal kickbacks and bribes to telemedicine companies in exchange for doctors’ orders for expensive cancer genetic tests. The doctors’ orders were written by doctors contracted with telemedicine companies, even though those telemedicine doctors had no prior relationship with the beneficiaries, were not treating the beneficiaries for cancer or symptoms of cancer, did not use the test results in the treatment of the beneficiaries, and did not conduct a proper telemedicine visit.

According to court documents, all three men sold these signed doctors’ orders for cancer genetic tests to labs in exchange for illegal kickbacks.

The full Department of Justice release can be read here:

Three Florida Men Charged in $46 Million Health Care Fraud, Kickback, and Money Laundering Conspiracy

What to do next…

  1. If you need help with an audit appeal or regulatory compliance concern, contact us at (800) 635-4040 or via email at [email protected].
  2. Read more about our: Total Compliance Solution

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