One of the fastest growing areas of Medicare fraud is genetic testing fraud or DNA testing fraud. The Department of Justice is offering huge monetary whistleblower rewards for reporting DNA testing fraud. Medicare does cover certain genetic tests when a patient has a history of certain types of illnesses, such as breast cancer and tumors that can be treated with chemotherapy. However, there are very specific requirements that must be followed for the costs to be eligible. This article shows you how to detect and report Medicare DNA fraud and apply for a reward. If you worked for a company that bills Medicare for DNA tests and are ready to report genetic test fraud, click on this link:
https://www.howtoreportfraud.com/confidential-federal-and-state-fraud-questionnaire/
Examples of DNA test fraud
Medicare/Medicaid only pays for only those DNA Tests that are “reasonable and necessary” for the diagnosis or treatment of the beneficiary. 42 U.S.C. § 1395y(a)(1)(A). DNA tests must be ordered by a physician, and labs must keep the orders in a patient’s case file. However, screening services, such as pre-symptomatic genetic tests and services, are those used to detect an undiagnosed disease or disease predisposition, and as such are not covered by Medicare. Similarly, DNA Tests that are performed without physician orders or an assessment of the patients’ needs are ineligible for Medicare reimbursement.
It is Medicare fraud for a DNA test company to bill Medicare for genetic tests that not based on an individual assessment of the patients’ needs, but instead for general screening/investigational purposes to detect an undiagnosed disease or disease pre-disposition. It is also Medicare fraud to bill DNA tests performed by sales representatives without any physician pre-approval.
Example of whistleblower rewards for reporting DNA test fraud
The Department of Justice paid a $30 million reward under the False Claims Act to a whistleblower who reported his employer for medically unnecessary DNA tests. See Millennium Health Agrees to Pay $256 Million to Resolve Allegations of Unnecessary Drug and Genetic Testing and Illegal Remuneration to Physicians, U.S. Dep’t of Justice, Office of Public Affairs (Oct. 19, 2015), https://www.justice.gov/opa/pr/millennium-health-agrees-pay-256-million-resolve-allegations-unnecessary-drug-and-genetic.
Contact Mr. Hesch to review your whistleblower DNA fraud case
Mr. Hesch would be pleased to review in complete confidence your allegations of DNA or genetic test fraud. He will determine in strict confidence if he believes you have a case where a significant reward is possible and can discuss the risks and rewards with you before you decide to report Medicare DNA genetic test fraud. Just click this link to fill out a form to reach Mr. Hesch:
https://www.howtoreportfraud.com/confidential-federal-and-state-fraud-questionnaire/
You can also read at the following link his extensive experience as an attorney working for the Civil Fraud Section of the U.S. Department of Justice (DOJ) in the whistleblower reward office.
https://www.howtoreportfraud.com/about-us/representative-cases/
Not only did Mr. Hesch work for more than 15 years in the Washington, D.C. DOJ office that pays nation-wide whistleblower rewards, but for the past 10 years he has represented clients, including doctors, nurses, auditors, managers and many other types of employees report their company for committing Medicare fraud. He currently is representing employees that worked for DNA genetic test companies in filing for whistleblower rewards.
If you work for a company that bills Medicare for DNA genetic tests, contact Mr. Hesch to find out if you have the right type of case to receive a reward.