Employees of a Texas laboratory have been caught in an elaborate scheme targeting military members with Tricare, offering $50 Walmart gift cards in exchange for DNA, urine samples and insurance information, according to a CBS News report.
Undercover video footage captured by the news outlet showed Dustin Warren, a salesman with Cockerell Dermatopathology in Dallas, Texas, telling reporters that the lab was billing Tricare $12,000-$16,000 for each genetic test, but scaled it back to $8,000 per test amid concerns that they would catch onto the scheme. The laboratory set up a clinic outside of Fort Hood where it enticed military personnel to provide samples of DNA and urine in exchange for $50 Walmart gift cards.
Cockerell Dermatopathology also used the samples to bill Tricare for unnecessary drug screening tests amounting to more than $5 million last year. In one instance, the insurer paid nearly $7,000 for 418 different tests for a single patient, says the article.
In a follow-up story, federal authorities told CBS News they had opened a criminal investigation against the laboratory. Cockerell Dermatopathology released a statement saying that the company terminated the individuals who violated the company’s compliance policies and is “voluntarily refunding monies resulting from these activities.”
During fiscal year 2015, Tricare saw an explosion of compounding pharmaceutical claims, amounting to $1.75 billion. Genetic testing has been a focal point for some insurers amid questions about how they should be integrated into medical care. Some experts have also referred to drug screening as a “money spigot” for nefarious providers.
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