Watch Out for DNA Scams

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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, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.