Grassley calls out HHS on response to genetic testing fraud after DOJ arrests

Chuck Grassley speaking
Sen. Chuck Grassley, R-Iowa, took the Department of Health and Human Services to task for not doing enough to combat genetic testing fraud in Medicare. (Gage Skidmore/CC BY-SA 2.0)

Sen. Chuck Grassley, R-Iowa, charged the Department of Health and Human Services (HHS) is taking the threat of Medicare fraud from genetic testing too lightly.

Grassley wrote to HHS leaders Tuesday, a few days after the Department of Justice (DOJ) charged 35 people in one of the largest healthcare fraud schemes ever. The scam centered on defrauding Medicare beneficiaries by offering free genetic tests then using their information to bill Medicare.

Grassley said he wrote to HHS and the Centers for Medicare & Medicaid Services (CMS) back in January after the Government Accountability Office (GAO) issued a report concerned about HHS’ ability to detect fraud in laboratory tests.

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“In light of the GAO report and recent news reporting about the abuse of genetic lab tests covered by Medicare, I remain concerned about the steps HHS has taken to ensure only appropriate payments are made,” Grassley wrote to HHS Secretary Alex Azar and CMS Administrator Seema Verma Tuesday.

Grassley pressed CMS and HHS to declare the steps they have taken to clamp down on genetic testing fraud. He also wants to know how many genetic screening tests have been paid for by taxpayers.

DOJ charged that the nearly three dozen people fraudulently billed Medicare for more than $2.1 billion for cancer genetic tests.  

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The defendants allegedly recruited marketers to approach seniors to get free genetic tests for cancer and other ailments. The recruiters would get these seniors' Medicare information that would then be allegedly used for either identity theft or fraudulently billing Medicare, the DOJ said.

HHS did not immediately return a request for comment.

Grassley has been pressing for several changes over the years to the management of Medicare. He lately has been touting a drug prices bill alongside Sen. Ron Wyden, D-Oregon, that would cap costs for Part D drugs to only the increase in inflation. While the bill passed out of the Senate Finance Committee, which Grassley chairs, it has not reached the Senate floor.

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Ochsner Health System is partnering with Color to launch a population health pilot program to integrate genetic information into preventive care.

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