Category: Tips

genetic testing scams target older adults with dna double helix image

Genetic Testing Fraud Targets Older Adults

Protecting Yourself and Your Medicare Coverage

Article by Texas Senior Medicare Patrol

Genetic testing scams are currently a widespread issue throughout the country. Scammers are offering Medicare beneficiaries cheek swabs for genetic testing to obtain their Medicare information for identity theft or fraudulent billing purposes.

What is Genetic Testing Fraud?

Genetic testing fraud occurs when Medicare is billed for a test or screening that was not medically necessary and/or was not ordered by a beneficiary’s treating physician.

What are Examples of Genetic Testing Fraud?

  • A company offering you “free” testing without a treating physician’s order and then billing Medicare. These tests go by many names and claim to test for many things. Here are some examples of ways you may see this advertised:
    • Cancer screening / test
    • DNA screening / test
    • Hereditary cancer screening / test
    • Dementia screening / test
    • Parkinson’s screening / test
    • Pharmacogenomics – medication metabolization
  • A company providing a test or screening that you never requested or that you do not need.
  • A company billing Medicare for screening services that are not covered by Medicare or for screenings that do not apply to you.
  • A company requesting your Medicare number at a community event, a local fair, a farmer’s market, a parking lot, or any other event.

What Happens if Medicare Denies the Genetic Test Claims?

You could be responsible for the entire cost of the test! The average is $9,000-$11,000.

What Can You Do to Stop Genetic Testing Fraud?

  • Be sure your doctor has assessed your condition. Although Medicare covers many genetic tests for diagnostic use, it only covers one preventative genetic test to screen for cancer.
  • Do not give out your personal information or accept screening services from someone at a community event, a local fair, a farmer’s market, a parking lot, or any other event.
  • Always read your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB). The words “gene analysis,” “molecular pathology,” or “laboratory” may indicate questionable genetic testing has occurred.
  • If you received a cheek swab or a screening that was not medically necessary, report your concerns about billing errors or possible fraud and abuse to your local SMP.Do not allow speakers to collect Medicare numbers from attendees.

How the Texas Senior Medicare Patrol (SMP) Can Help

The Texas SMP is ready to provide you with the information you need to PROTECT yourself from Medicare fraud, errors, and abuse; DETECT potential fraud, errors, and abuse; and REPORT your concerns. SMPs and their trained volunteers help educate and empower Medicare beneficiaries in the fight against health care fraud. The Texas SMP can help you with your questions, concerns, or complaints about potential fraud and abuse issues. It also can provide information and educational presentations.


When are Genetic Tests Covered?

  • When someone has stage III or IV cancer
  • When the test is medically reasonable and necessary
  • Federal regulations define medical necessity as “services or items reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.”
  • When it is ordered by a treating physician
  • Federal regulations define a treating physician as “the physician who furnishes a consultation or treats a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary’s specific medical problem. Tests not ordered by the physician who is treating the beneficiary are not reasonable and necessary.”
  • When one or more coverage requirements are met for colorectal cancer genetic screening
  • There is no other Medicare coverage for genetic testing as a screening service.
  • When a treating physician orders the test as a diagnostic service and uses the results to manage the patient’s condition

How are Fraudsters Benefiting from Genetic Testing Fraud?

See the chart for why this is becoming more prevalent. These services are not free. Each cheek swab could potentially make the company thousands of dollars by billing Medicare and/or you for services that were not needed.

Example Charges for One Cheek Swab


More Tips from the Centers for Medicare & Medicaid Services

Download and share the fact sheet from to keep yourself and your loved ones protected from genetic testing scams.

508_eob-genetic-testing-fraud-1-_page_1 508_eob-genetic-testing-fraud-1-_page_2

Supported by a grant (No. 90MPRC0001) from the Administration for Community Living (ACL), U.S. Department of Health and Human Services (DHHS).

Worried elderly man and woman

Protecting Seniors from Health Care Fraud

Health Care Scams Cost Medicare Beneficiaries Billions

Article by Senior Medicare Patrol

The Medicare program and Medicare beneficiaries lose an estimated $60 to $90 billion each year to health care fraud as older adults are increasingly targeted by scam artists. This fact sheet provides basic information and tips you can use to help prevent health care fraud in your facility.

Senior center and senior housing staff are in a unique position to help protect their clients from unscrupulous practices that take money away from much-needed programs and from older adults.

Your clients trust you and often believe that any product, service or activity that your organization directly or indirectly promotes has been properly checked out.

You should know about fraud schemes targeting your community and have practices in place to safeguard your clients. Your local SMP can educate you about local fraud and scams.

Common Health Care Scams that Affect Beneficiaries

  • Services Not Provided – beneficiaries are billed for services never received or health care providers change billing codes or submit fake claims.
  • Medical Equipment Fraud – equipment manufacturers may offer “free” products or waive required copayments or deductibles in exchange for a Medicare number.
  • Free Health Screenings – a vendor offers to provide “free” health care screenings, lab tests or other services but asks for a person’s Medicare number.
  • Insurance Bait & Switch or Cross-selling – licensed agents present information about a Medicare Advantage plan, describing benefits and services that the plan doesn’t actually offer, and then sign people up for a plan that isn’t right for them.
  • Counterfeit Prescription Drugs – beneficiaries purchase medication over the Internet to save money, but the drugs they receive are not the right medication or the right dosage.
  • Medical Identity Theft – this can happen when someone uses a person’s Social Security number or Medicare number, date of birth, credit card number or other personal information. This information can be obtained by asking for it at an event or over the phone or stealing information from a wallet or the trash.

Tips for Protecting Your Clients & Your Organization

  • Do not allow presenters to get names and telephone number from participants.
  • Screen any group that wants to provide information or services to your community – see if they are an approved agency or licensed business. Check with your local SMP, Better Business Bureau or state department of insurance, as appropriate, for complaints.
  • Review all materials that are distributed or promoted in your organization.
  • For any agencies, organizations or individuals who want to offer services through your organization, create written agreements that clarify roles and responsibilities.
  • Know Medicare marketing guidelines—e.g., Medicare does not call to ask for sensitive personal information and forbids unsolicited telemarketing, e-mail marketing, and sales of Medicare-related products and services.
  • Be wary of any entity that offers FREE prizes, meals, groceries, low-cost health care products, nutritional supplements or inexpensive vacations, or says that Medicare will pay for it. Watch for high-pressure sales tactics.
  • Consider making fraud awareness training an ongoing priority for your staff.

Guide for Inviting Outside Speakers to Your Organization

  • Do not allow speakers to collect Medicare numbers from attendees.
  • Request a biography from the speaker in writing before the presentation.
  • Check references for agencies or organizations; ask about them in your senior network; and check out potential speakers.
  • Do not allow a “sales pitch.”

How Your Senior Medicare Patrol (SMP) Can Help

The local SMPs are ready to provide Medicare beneficiaries with the information they need to PROTECT seniors from Medicare errors, fraud and abuse; DETECT potential errors, fraud, and abuse; and REPORT their concerns. SMPs use trained senior volunteers to help educate and empower older adults in the fight against health care fraud. The local SMP can help beneficiaries with questions, concerns or complaints about potential fraud and abuse issues. It also provides information and speakers for your facility.


For assistance, call the Texas SMP program at 713-341-6184 or 1-888-341-6187.

For more information or to locate your state SMP, visit
Supported by grant number 90NP0001/01 from the U.S. Administration on Aging (AoA), Department of Health and Human Services.



Transfer on Death Deed Workshop

transfer on death deed workshop flyer

Transfer property to your heirs and avoid the probate process by filing a Transfer on Death Deed. Join us for this free workshop and learn information and requirements from Paul J. Zambie with the Texas Legal Services Center. This workshop will be held at the CTCOG building, 2180 N. Main Street in Belton, on June 27 at 10 A.M. to noon. Please RSVP by calling 254-770-2330 or 254-770-2342.

apply for weatherization assistance

Weatherization Assistance Available for Low-Income Families

Reduce Energy Costs with Help from Hill Country Community Action, Inc.

If you receive Supplemental Security Income (SSI), VA Means-Tested Program Income, or otherwise qualify for assistance, you could receive free installation of weatherization materials and education. Services you may qualify for include:

  • Ceiling, wall, and floor insulation
  • Caulking/weather stripping
  • Duct sealing/air infiltration measures
  • Tune up or replacement of inefficient heating & cooling systems/appliances
  • Refrigerator
  • Energy Star Windows
  • Water heater insulation
  • Water heater pipe insulation
  • LED bulbs
  • Low-flow showerheads

The Hill Country Coummunity Action, Inc. is accepting applications to help control energy costs. Find your nearest location below to apply today.

Hill Country Community Action Centers Directory

tips to reduce stress

10 Tips for Managing Stress with Alzheimer’s

Living with Alzheimer’s or caring for loved ones with dementia brings demands and may feel overwhelming. Too much stress affects your health and ability to function. Follow these 10 tips shared by the Alzheimer’s Association to reduce stress and improve concentration and decision-making:

  1. Maintain a positive attitude.
  2. Acceptance is key–all you can control is how you react and adjust.
  3. People can’t help if they don’t know there is a problem–be honest and open with your feelings.
  4. Relax–taking time to breathe is so important.
  5. Get moving–exercise can help reduce stress.
  6. Take it one day at a time–if it’s not an emergency situation, do not turn it into one.
  7. Sleep is important–a good night’s rest keeps us functioning at our best.
  8. Incorporate stress management techniques into your life–be social and have fun!
  9. Eat a balanced, healthful diet full of fruits, vegetables, and water.
  10. Set realistic goals and go slow–life is not a race, rather, it is a journey.

Finding ways to reduce caregiver stress will help lessen the long-term emotional and physical toll of caregiving. If you need help, contact us for more resources. More tips and symptoms of stress are available at

TDT article Alzheimers Caregiver Workshop

Alzheimer’s Caregiving Workshop in the News

TDT article Alzheimers Caregiver Workshop
Read the complete article at

Caregiving Tips for Alzheimer’s and Dementia

Thanks again to Delia Jervier from the Capital of Texas Chapter of the Alzheimer’s Association for visiting AAACT at Central Texas Council of Governments this past week. Jervier shared great insight on caregiving for dementia and Alzheimer’s patients. One point she discussed was that as loved ones digress, there is a tendency to revert to their native language, making communication with facility staff difficult. One example she gave was a Korean woman in Austin who had reverted to her native language and diet, making it impossible to find a care center for her.

Jervier also mentioned that although training is necessary for caregiving, it requires more hours of training to learn how to groom pets that it does to learn how to work with dementia patients.

“People who care for people with dementia don’t get an adequate amount of training for the type care needed by individuals with Alzheimer’s,” Jervier said.

Jervier also stressed that early diagnosis will help the individual with the disease to become more involved in the decision-making process. The 10 early signs of Alzheimer’s she shared include:

  1. Difficulty remembering things that just happened
  2. Inability to plan or solve problems
  3. Losing track of dates, seasons, and time
  4. Misplacing things
  5. Mood and personality changes
  6. Poor decision-making
  7. Struggling with conversations
  8. Trouble completing familiar tasks
  9. Vision problems
  10. Withdrawal from social or work activities

Thank you to Temple Daily Telegram for covering this workshop. To read the complete article, visit

AARP HomeFit Guide

Home Fit Modifications Guide

Reduce Fall Risks for Seniors with Home Modifications


Hazards in the home can add up over time, increasing the risk for falls–a top reason why seniors loss independence and mobility. Check out a room-by-room modification guide from AARP that takes you through the entire house explaining specific changes that are necessary to keep seniors safe. Some highlights include:

  • Good lighting, essential for seniors because aging eyes need much more light than younger ones
  • Visual shopping guide with pictures of recommended home safety modification items
  • Keeping things within reach, making it easier for those who are frail or weak
  • Evaluating outdoor hazards as well as indoor ones
  • Simple to-do lists that separate the tasks you can do yourself from those that may require a handyman or contractor
  • Other helpful online resources to learn about home modifications for older adults

Download the entire HomeFit Guide from AARP below:

AARP HomeFit Guide
Smart solutions for making your home comfortable, safe and a great fit