10.02.19

Whitehouse, Cassidy, Hassan Applaud DOJ Action Against $2.1B Medicare Fraud Scheme

WASHINGTON–  U.S. Senators Sheldon Whitehouse (D-RI), Bill Cassidy, M.D. (R-LA), and Maggie Hassan (D-NH) today released statements applauding the Department of Justice (DOJ) and the Department of Health and Human Services’ (HHS) action against 35 individuals for their alleged participation in a Medicare genetic testing fraud scheme involving $2.1 billion in losses, and the departments’ new effort to target genetic testing fraud schemes nationwide. This action comes a month after the group of Senators contacted DOJ and DHS to highlight and request action on the issue.

“I’m pleased that the Department of Justice and the Department of Health and Human Services cracked down on this scam after we brought it to their attention,” said Whitehouse.  “This action will protect seniors from Medicare fraud and save taxpayer dollars.”

“This action is a huge victory, putting an end to this massive scam operation,” said Dr. Cassidy. “We need Congress, HHS and DOJ all working together to protect seniors from Medicare fraud.”

“I am glad that the Department of Justice and the Department of Health and Human Services are heeding our calls to go after the criminals who preyed on seniors and cost Medicare more than $2 billion,” Senator Hassan said. “This fraudulent scheme defrauded taxpayers, and I am pleased that federal prosecutors are working to bring these scammers to justice.”

In the alleged scheme, recruiters (aka marketers) get a Medicare beneficiary to take a genetic test. The recruiter then gets a doctor to sign off on the genetic test so a lab will process the test. The recruiter pays the doctor a kickback in exchange for ordering the test. Then the lab processes the test and bills Medicare. Medicare reimburses the lab for the test and the lab shares the proceeds of that payment with the recruiter. This enforcement action shows the positive impact OIG is making to fight fraud and protect HHS programs and beneficiaries.

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