𝗢𝗻𝗲 𝗼𝗳 𝘁𝗵𝗲 𝗹𝗮𝗿𝗴𝗲𝘀𝘁 𝗵𝗲𝗮𝗹𝘁𝗵 𝗰𝗮𝗿𝗲 𝗳𝗿𝗮𝘂𝗱 𝘀𝗰𝗵𝗲𝗺𝗲𝘀 𝗲𝘃𝗲𝗿 𝗰𝗵𝗮𝗿𝗴𝗲𝗱 𝗯𝘆 𝘁𝗵𝗲 𝗨𝗦 𝗗𝗲𝗽𝗮𝗿𝘁𝗺𝗲𝗻𝘁 𝗼𝗳 𝗝𝘂𝘀𝘁𝗶𝗰𝗲 𝘄𝗮𝘀 𝗳𝗼𝗿 𝗚𝗘𝗡𝗘𝗧𝗜𝗖 𝗧𝗘𝗦𝗧𝗜𝗡𝗚! Variations of 𝘁𝗵𝗲 𝗳𝗿𝗮𝘂𝗱 𝗮𝗿𝗲 𝗼𝗻𝗴𝗼𝗶𝗻𝗴 𝗮𝗻𝗱 𝗻𝗮𝘁𝗶𝗼𝗻 𝘄𝗶𝗱𝗲, and so severe that the US HHS Office of Inspector General maintains a website, with a professionally produced short video warning people about the fraud scheme: https://lnkd.in/gJbpE4Un
𝗨𝗻𝗳𝗼𝗿𝘁𝘂𝗻𝗮𝘁𝗲𝗹𝘆 𝗖𝗢𝗩𝗜𝗗 𝗽𝗿𝗲𝘀𝗲𝗻𝘁𝗲𝗱 𝗮 𝗺𝗮𝗴𝗻𝗶𝗳𝗶𝗰𝗲𝗻𝘁 𝘄𝗮𝘆 𝗳𝗼𝗿 𝘂𝗻𝗲𝘁𝗵𝗶𝗰𝗮𝗹 Clinical Genetics 𝗹𝗮𝗯𝘀 𝗮𝗻𝗱 𝗺𝗶𝗱𝗱𝗹𝗲𝗺𝗲𝗻 𝘁𝗼 𝗮𝗺𝗽𝗹𝗶𝗳𝘆 𝘁𝗵𝗲 𝗳𝗿𝗮𝘂𝗱. COVID samples were used to also run unnecessary hereditary cancer tests which were (still are?) billed payers.
For the SIU folks at Health Insurance Payers, quickly view the attached slides to learn how to easily spot in your claims data potential COVID era patient recruitment fraud for hereditary cancer testing.
And while we at the nonprofit Center for Genomic Interpretation are happy to help payers find fraudulent patient recruitment and fraudulent billing from Cinical Genetics and Genomics labs, the biggest waste of HealthCare dollars is actually due to inaccurate and low quality genetic and genomic tests. The downstream care of plan members which is misguided by the plethora of inaccurate diagnostic tests likely costs far more than any billing fraud scheme out there in Precision Medicine. That’s why we provide #ELEVATEGENETICS services: genomicinterpretation.org/elevategenetics/ . We help payers figure out which genetic and genomic tests are accurate, and which are not. Because “most genetic tests today are not regulated, meaning that they go to market without any independent analysis to verify the claims of the seller” – (This is a warning from the NIH found here.