Watch Out for DNA Scams

Silhouette of lonely elderly man walking with a walker near the window at home

It appears that a new wave of Medicare fraud scams involving DNA testing has been detected. Whether lured by free ice cream or scared of potential life-threatening illnesses, senior citizens are being deceptively convinced to provide their Medicare number in exchange for a cheek swab. A laboratory sales representative from New Jersey is the latest person to be convicted in a Medicare fraud scheme that bilked the government healthcare program of more than $430,000. (Fortunately, the Medicare fraud scam was halted before plans to expand it to 11 other states were carried out.)

The New Jersey lab sales rep supposedly worked for a non-profit organization that helped aging adults navigate federal benefits programs. However, the group was actually a front used to present information about genetic testing. For about a year-and-a-half, today’s offender and other co-conspirators invited senior citizens to community rooms at low-income seniors housing complexes. Part of his schtick warned attendees that if they did not undergo genetic testing, they would be prone to heart attacks, strokes, cancer and suicide. (You can see why many fell for the scheme.)

Today’s criminal and his co-conspirators took DNA swabs from the attendees, then recruited healthcare providers from Craigslist to authorize testing after it had already been done. (It’s important to note that today’s fraudster neglected to tell his audience that he was a sales representative for the laboratories that processed the results of the DNA swab.)

The recruited healthcare providers were paid thousands of dollars each month by today’s fraudster to fake exams for the senior citizens they never saw or treated. As a result, Medicare paid out more than $1 million in fraudulent claims. (The defendant and his co-conspirators split about $100,000 in commissions to keep the victim pipeline full.)

The New Jersey laboratory sales representative was sentenced to more than four years behind bars for convincing senior citizens that they needed genetic counseling without seeing a medical professional. His deceptive Medicare fraud scheme cost the government healthcare program more than $430,000. He also received three years of supervised release following his prison term along with the requirement to pay restitution of $66,844.

Today’s “Fraud of the Day” is based on an article, “Lab sales rep sentenced for $430,000 in Medicare fraud involving senior housing residents,” published by McKnight’s Senior Living on May 15, 2019.

A laboratory sales representative has been sentenced to more than four years in prison for defrauding the Medicare program of more than $430,000 while convincing residents of affordable senior housing communities to submit to genetic testing without seeing a healthcare professional, according to the Justice Department.

Seth Rehfuss previously pleaded guilty to one count of conspiracy to commit healthcare fraud.

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Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.