With genetic testing becoming more common, whistleblowers should be on the lookout for schemes to defraud Medicare and other government healthcare programs.

Genetic testing can allow healthcare providers to screen patients for predispositions to certain cancers or other diseases, as well as risk factors for certain medications.  These services are susceptible to fraud because of  their high reimbursement rate from government healthcare programs.

Genetic testing fraud can come in many forms.  One common scheme is to bill Medicare for tests that are not medically necessary.  Medicare guidelines are particularly strict on when providers are reimbursed for genetic tests.  Another common scheme involves illegal kickbacks, either to providers or to marketers who find potential patients.  Finally, some providers illegally waive copays for Medicare patients, in an attempt to induce patients to take these expensive genetic tests.

Although genetic testing is on the rise, whistleblowers can help combat this waste and abuse of public funds.   Under the False Claims Act, whistleblowers who uncover fraud against the government can bring a civil action and share in any recovery.

If you have uncovered fraud against the government, contact the whistleblower lawyers at Miller Group for a free and confidential consultation.  You can also set up a consultation by calling us at (919) 348-4361.

Additional Resources: 

Medicare and Medicaid Fraud: The Reverse False Claim and the 60-Day Rule

What is medical bill upcoding and why should I worry about it?

Recent Developments in Whistleblower Protection