Page 24 - Amarillo Senior Link Magazine Winter 2021 - Online Magazine

SENIOR RESOURCES

Cardiovascular

Genetic Testing

Genetic testing scams quickly emerged • Billing Medicare (usually thousands covers many genetic tests to detect
in 2019, targeting cancer screening of dollars) for a broad range of heart disease, it is not a test to predict
and pharmacogenetics (medication cardiac genetic tests that you did not or screen for cardiovascular disease.
metabolization). The latest growing request or possibly even receive.
genetic testing fraud trend focuses • Do not give out your personal
on cardiovascular genetic testing. • A company calls you stating your information to someone calling,
Scammers are offering Medicare doctor or cardiologist requested that claiming your cardiologist has
beneficiaries cheek swabs for genetic you have the testing done, and they requested the testing.
testing to obtain their Medicare will send you a testing kit.
information for fraudulent billing • Do not give out your personal
purposes or possibly medical identity What Happens if Medicare information or accept screening
theft. Denies the Cardiovascular services from someone at a community
Genetic Test Claims? event, a local fair, a farmers’ market, a
What is Cardiovascular parking lot, or any other event.
Genetic Testing Fraud? • You could be responsible for the
entire cost of the test. • Always read your Medicare
Cardiovascular genetic testing fraud Summary Notice (MSN) or Explanation
occurs when Medicare is billed for a When is Cardiovascular of Benefits (EOB). The words “gene
cardio type of test or screening that Genetic Testing Covered by analysis,” “molecular pathology,” or
was not medically necessary and/ Medicare? “laboratory” may indicate questionable
or was not ordered by a beneficiary’s • When the test is medically reasonable genetic testing has occurred.
treating physician.
and necessary. Federal regulations • If you received a cardiovascular
What are Examples of define medical necessity as “services genetic testing kit or test that was
Cardiovascular Genetic or items reasonable and necessary for not medically necessary, report your
Testing Fraud? the diagnosis or treatment of illness or concerns about billing errors or
injury or to improve the functioning of a possible fraud and abuse to your local
Here are several ways cardiovascular malformed body member.” SMP.
genetic testing is advertised:
• When it is ordered by a treating Texas Senior Medicare Patrol
• Cardio/cardiac genetic screening/test physician. Federal regulations define (SMP) Can Help!
a treating physician as “the physician
• Comprehensive cardiovascular panel who furnishes a consultation or treats Texas SMP is ready to provide you
a beneficiary for a specific medical with the information you need to
• Comprehensive cardiomyopathy problem and who uses the results in the PROTECT yourself from Medicare
NSG management of the beneficiary’s specific fraud, errors, and abuse; DETECT
medical problem. Tests not ordered by the potential fraud, errors, and abuse; and
• Cardiovascular disease genetic kit
physician who is treating the beneficiary REPORT your concerns.
• Hereditary cardiovascular profile are not reasonable and necessary.” CONTACT: 1-888-341-6187 OR
• A company offering you “free” or • When a treating physician orders the 713-341-6184
“at no cost to you” testing without a test as a diagnostic service and uses FOR LOCAL ASSISTANCE AND
treating physician’s order and then the results to manage the patient’s QUESTIONS, CONTACT THE AREA
billing Medicare. condition. AGENCY ON AGING 806-331-2227
• A company using “telemedicine” to What Can You Do to Stop OR 1-800-642-6008
offer testing to you over the phone Cardiovascular Genetic
and arranging for an unrelated Testing Fraud?
physician or “teledoc” to order the
tests. • Be sure your doctor has assessed
your condition. Although Medicare

24 Amarillo Senior Link