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Legality of Doing Genetic Cancer Screenings at Health Fairs

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hyjyljyj

Member
What is the name of your state? FL

A company called XXYZ is offering an opportunity for 1099 contractors to work health fairs, over-55 communities, state fairs, etc., conducting genetic testing for cancer and drug interactions. You set up a table with banners announcing no-cost genetic screening called CGX (cancer genomics) and PGX (pharmaceutical genomics). You do a medical-necessity questionnaire with each person to see if their DNA profile means they may have a risk to get cancer or have drug interactions. The tests are reimbursed by Medicare or insurance, and reps are told they can earn up to $200k-500k+ per year, or $250-500 per correctly completed 20-minute screening, including each person swabbing their own cheek for a DNA sample, and using a telemedicine doctor to get a prescription for the test(s).

The CEO of a site unaffiliated with this marketing concept, however, insists he has tried but that it is illegal for laypersons to conduct these screenings at health fairs etc., without the permission of each person's primary care doctor (not the telemedicine doctor) and/or a family member. He was emphatic that it cannot be done on a 1099 basis, must be W-2 and be done by signing up medical practices directly to do the screens instead—and that there is a $25,000 fine and up to 5 years in prison for doing the screenings at health fairs, etc. without the primary care doctor's knowledge or consent.

Which one is true? Is this legal to do, or no? How do I verify? What government body would have jurisdiction over this to say yea or nay?

Thanks in advance
 


PayrollHRGuy

Senior Member
XXYZ wants to place people to do this screening for the unaffiliated site? If that is the case it matters not what the law is.
 

FlyingRon

Senior Member
I think there's a log of hokum on all sides of it. First off, it is not the case that a person needs permission of his primary care doctor to do anything. There may be some requirement by his insurance company to get a referral from the primary before they'll pay for it but that's a different issue. I'm not even sure whether the screener is an employee (W-2) or a contractor (1099) makes any difference at all.

Note that the FDA does heavily regulate the marketing of screening products to the public. You can't just hang out a banner and say you are doing testing that diagnoses anything without approval of the tests involved.

I've got my doubts as to whether insurance and Medicare is going to fund any of this. Medicare only covers genetic testing in very limited circumstances (history of certain cancers with familial history fo the same). Similarly, most insurance will only cover it if there's a family history of hereditary cancer. This is not one of the things the ACA mandates insurers cover except in the most limited of circumstances.

The whole thing smells like SCAM to me. Medical professionals don't typically work on commission and $500K a year is laughable. If that were possible, many practitioners would be out doing that rather than slogging through primary care and having to pay malpractice claims.
 

hyjyljyj

Member
XXYZ wants to place people to do this screening for the unaffiliated site? If that is the case it matters not what the law is.
No. The unaffiliated site is separate from XXYZ, unrelated, not doing what XXYZ is doing.

Also, I'm not familiar with a situation where it matters not what the law is. Could you clarify a little? Thank you!
 

LdiJ

Senior Member
The CEO of that site is the one who says this is illegal. I'm trying to find out the truth.
How did the CEO of that site get involved at all in expressing an opinion? What caused him to express an opinion? You are not answering the question that you are being asked.
 

PayrollHRGuy

Senior Member
No. The unaffiliated site is separate from XXYZ, unrelated, not doing what XXYZ is doing.

Also, I'm not familiar with a situation where it matters not what the law is. Could you clarify a little? Thank you!
The CEO of that site is the one who says this is illegal. I'm trying to find out the truth.
Answered twice.
No you didn't. How is the unaffiliated site involved at all? I aksed, in post number two. "XXYZ wants to place people to do this screening for the unaffiliated site? If that is the case it matters not what the law is."

If the unaffiliated site is who is in some way paying for anything it doesn't matter what the law is if they want to use medical professionals.
 

PayrollHRGuy

Senior Member
It's another lab I called as part of my due diligence that does genetic testing (but not in concert with XXYZ).
Thank you for FINALLY answering my question. The CEO is probably half right. It probably requires some sort of medical certification but the whole W2 v. 1099 is BS.
 

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