What This Story Is About
- A west Nashville couple, Doug Leins and his wife, were billed through their Medicare supplemental insurance for genetic testing they never requested. Separately, unsolicited medical equipment — two knee braces and a back brace — arrived at their home that they never ordered. This is part of a broader pattern of Medicare fraud that WSMV4 Investigates has been reporting on in Middle Tennessee.
Why It Matters
- Fraudulent charges billed to Medicare supplemental insurance count against a policyholder’s annual coverage totals, reducing what legitimate medical services can be covered for the rest of the year. The Leins also face a potential $1,329 out-of-pocket charge. The fraud affected both spouses simultaneously, with identical charges from two different labs — one in Arizona, one in Utah — neither of which had working phone numbers.
- The Leins have reported the fraudulent genetic testing charges to their Medicare supplemental insurance provider. They are also waiting on their quarterly Medicare report to see if Medicare separately paid out for the genetic testing. They still do not know what insurer — if any — was billed for the knee and back braces that arrived in the mail.
For Context
- Medicare is typically billed before supplemental insurance. Data breaches are often the primary way Medicare ID numbers reach criminals.
NASHVILLE, TN (WSMV) – A west Nashville couple says they were targeted by Medicare fraud twice — first through fraudulent genetic testing charges billed to their Medicare supplemental insurance, and then when unsolicited medical equipment arrived at their home.
Doug Leins said neither he nor his wife requested genetic testing, and neither did their doctor.
“We knew for a fact that we had never requested that and that our doctor had never requested that,” Leins said. “This fraud is just so rampant.”…