NORFOLK, Va. (WAVY) — Doctors want to warn patients of a Medicare fraud scheme involving unnecessary genetic test kids that is making the rounds in the Hampton Roads region.
Patients in our area received packages in the mail with a genetic test inside and thought it was ordered by their doctor, so they took the swab and sent it back to the lab. But doctors said that’s the first step in a multi-million-dollar Medicare fraud scheme that’s lining these fraudster’s pockets with our tax money.
Dr. Anne Redding got suspicious when she saw paperwork on her desk wanting her to authorize DNA tests for a few of her patients.
“I was like, I did not order this, what is going on here? Then I got two in one day,” Redding said.
The patient told Redding that the lab called them asking for Medicare information and a list of their doctors — hoping one would just blindly authorize the paperwork. A quick search of the name — Reliable Results Lab, LLC — pulls up articles about doctors, civilians and the co-owners of the lab being indicted on Medicare and Medicaid fraud charges.
“I got really angry,” Redding said. “These are my patients. They’re older, they’re vulnerable and this behavior is just so reprehensible.”
Here’s how it works: when the doctor signs off to order the tests, the lab, owned by the schemers, does the tests and then bills Medicare or Medicaid for the cost. Each panel of tests can cost between $800 and $1,000. When Medicare or Medicaid reimburses them, the lab then gives a kickback to the doctor if they’re in on the scheme. Some medical professionals have been reported to have ordered 30 to 40 of these unnecessary tests in one day and received as much as $400,000 in kickbacks. Numerous people across the country have been indicted in cases spanning from Colorado to Texas and Florida.
“And they should,” Redding said. “This is Medicare fraud. And these are our taxes paying for this.”
Defrauding helpless elderly people hits home for Redding.
“My mother passed away a few years ago, but she had dementia, and she was subject to a fraud,” she said. “At that point she wasn’t really too bad, but once they get, you know, they’re just kind of on the edge, they’re just really sitting ducks for a lot of these scam artists.”
Redding says doctors should speak up when they know something’s not right.
“It is the honor of our profession that’s at stake.”
You can report the Medicare fraud cases to the FTC by going to https://reportfraud.ftc.gov/. To report fraud to Health and Human Services visit https://oig.hhs.gov/fraud/.