Telemedicine Fraud Targeting Cancer Providers Through “Genetic Lab Testing” Schemes

In recent months, we’ve seen a serious focus by the Department of Justice on telemedicine fraud. This trend has allegedly funneled over a billion dollars to companies and persons participating in these schemes – with unsuspecting medical professionals getting looped in at no fault of their own. Officials say these schemes have far-reaching effects and are warning providers and patients to be careful when solicited by telemedicine services.

As we previously mentioned, telemedicine fraud schemes take advantage of the surge in reliance on telemedicine by skipping any genuine medical examinations and instead funneling patients to a call center where often unnecessary medical equipment and treatments are provided and paid for through Medicare. Part of this practice involves genetic testing labs committing fraud.

Last month we mentioned how these schemes often target ​​durable medical equipment providers. Well-meaning medical providers who provide care to cancer patients have also been victimized by these schemes.

As with the other schemes, unsuspecting patients will be targeted through online and television advertisements providing a phone number for those who believe they may need the treatments. Once an individual calls the number, they reach a call center that pushes them through to until every single patient ends up being approved to go through genetic lab testing to determine whether or not they either have cancer or are predisposed to a specific type of cancer. These tests can be worth several thousand or even tens of thousands of dollars to the labs who run and charge for these “tests.”

What these patients don’t realize and aren’t told is that this type of genetic testing is generally not medically necessary in determining a patient’s likelihood to develop cancer. The scheme ignores this in order to secure significant compensation from Medicare. Medical providers may end up being accused of and indicted for paying illegal kickbacks as part of this process but are never looped in on the fact that the scheme is fraudulent and soliciting patients who do not need the lab testing. For better or worse, ignorance is not always a defense when accused of being involved in the commission of crimes.

It’s important to tread carefully whenever a marketer pushing telemedicine services reaches out to your medical office. It can be tempting to increase revenue through such means but these marketers often just need one doctor who isn’t aware of how these illegal schemes work to move forward. The consequences could be career and life altering.

Contact Barry M. Wax, Attorney at Law and get the legal advice you need before you find yourself on the wrong side of a criminal prosecution.