Coronavirus Fraud Takes Many Forms as Federal and Local Officials Continue to Pursue Widespread Cases of Clinical Laboratory Testing Scams
Federal investigators have been actively searching for trends of fraud in Medicare claims data for COVID-19 clinical laboratory research since the pandemic started.
According to media studies, dating back to at least March, fraudulent actors offering fake SARS-CoV-2 tests have preyed on vulnerable Americans in a wide range of ways during the public health emergency. In return for swab collections and fake testing, the New York Times reported, some scam operators have gone into nursing homes and long-term care facilities to raise money from unsuspected elders.
The federal Centers for Medicare and Medicaid Programs (CMS) no longer needs a laboratory test requirement signed by a treating physician or other provider for COVID-19 testing after the declaration of the public health emergency in the US. "The high demand for and restricted availability of SARS-CoV-2 samples, along with the decision by CMS to loosen rules during the pandemic for some test orders, makes the situation a potentially ripe one for fraud," said Modern Healthcare.
Moreover, a lack of clarification about the medical necessity of COVID-19 tests might increase the risk of liability for clinical laboratories that are law-abiding. All of these variables make COVID-19 fraud testing a possible bombshell for clinical laboratories performing coronavirus testing that could get caught up in federal research.
Feds Increasing Enforcement
The FBI, the Better Business Bureau (BBB), the FDA, the Federal Department of Health and Human Services ( HHS), and other federal and local authorities have repeatedly alerted physicians, hospitals, and healthcare customers about the potential for fraud by unscrupulous firms pretending to deliver COVID-19 legitimate clinical laboratory tests shortly after the pandemic arrived in the US. "Scammers are selling fraudulent and/or unapproved COVID-19 antibody tests, potentially providing false results," a June 26 FBI press release said.
Some of the fraudsters behind these scams have operated online and through social media and email. While others have conducted these scams in person or over the phone, noted the press release. And yet, the scams and news stories about them have continued to propagate during the COVID-19 pandemic, despite the warnings.
How Do The Fraudsters Work?
Fraudsters aim to collect personal information from customers in many of these scams, including names, birth dates, and social security numbers, as well as other types of personal health information, such as data from Medicare or private health insurance, the FBI said. Scammers can use the data in fraud schemes for medical insurance or to commit identity theft, the agency said.
In addition, any fraudulent or incorrect COVID-19 tests or assays not approved to be used by the FDA may give false results to physicians, potentially creating a dangerous situation for patients.
The New York Times (NYT) recently announced that a notice "about scammers selling fake COVID-19 antibody tests as a way to access personal information that can be used for identity theft or medical insurance fraud" was released by the FBI.
The BBB added an alert to its website three days after the FBI released its warning about the COVID-19 antibody testing scam:' BBB Scam Alert: Want a COVID-19 test? "There is a scam for that." BBB also provided customers with advice about how to stop scam checking.
The FDA announced on June 17 that it had given warning letters to three firms for the sale of adulterated and misbranded COVID-19 antibody tests, an FDA news release said. Warning letters have been sent by the department to:
The New York Times reported on April 17 that a special agent with the HHS OIG noted that impostors requesting information from Medicare or Medicaid posed as physicians or laboratory technicians in nursing homes and assisted living facilities to deliver fake tests.
The Texas Tribune reported earlier in April that the owner of a freestanding emergency room in Laredo, Texas, spent $500,000 on buying 20,000 COVID-19 rapid tests for patients suspected of having COVID-19. In Laredo, health officials decided to set up a drive-through testing site and then conduct tests to detect active infections from a manufacturer in China. City health officials learned they were ineffective and unusable after attempting to verify the samples.
An April 9 article from the AARP (American Association of Retired Persons) news department reported that in several states, including Alabama, Arizona, Florida, Georgia, Kentucky, New York, and Washington state, federal officials have found fake coronavirus testing sites.
According to AARP, the FBI investigated several fake test sites in Louisville, Ky., after a city official confirmed the collection of biological specimens from residents by individuals in personal protective equipment ( PPE). In order to prove their identity, those requesting tests were advised to pay $240 in cash or have their Medicare, Medicaid, or Social Security cards.
The AARP confirmed that fake drive-up testing sites were confirmed over a four-day period at gas stations and other locations in Louisville.
On April 2, WRGB TV in Albany, N.Y., announced that in return for bogus coronavirus tests, scammers claiming to be from the New York State Department of Health (NYSDOH) were taking money and insurance details from individuals. One woman told police that she had a fake test in a Little League parking lot at a drive-up spot.
North Greenbush police said the scammers described themselves as being with NYSDOH and obtained information from several individuals about money and insurance. Police and state officials said that in the parking lot, the DOH had no connection to the collection site.
Lessons for Laboratories
The message from these stories is to be vigilant of strangers providing COVID-19 testing for clinical laboratory directors and all clinical laboratory scientists, while also making sure to post information on the legitimacy of your laboratory's rapid molecular and serological tests to customers. Doing so could entail presenting evidence that the FDA has approved the coronavirus to be used for your studies.
Medical laboratories should also ensure that proper identification is demonstrated by all workers collecting specimens in public places.