Justin Judkins was approached at a shopping mall by a pretty young model, "all dolled up," wearing high heels, a white lab coat and electric blue wig.
The woman asked him if he wanted to be a hero and save a child's life. How could he say no?
Like thousands of other people, Judkins agreed to allow bone marrow registry workers to swab the inside of his cheek for a DNA test — lured by a recruiting pitch that an official with a national donor registry calls "a little unusual."
Now, authorities in New Hampshire and Massachusetts are investigating why the lab billed insurance companies more than $4,000 for the tests that were supposed to cost about $100 and whether the workers took samples from people who didn't qualify because of age or medical issues.
Senior Assistant Attorney General Jim Boffetti in New Hampshire said a staff member at UMass Memorial Health Care Inc. was in charge of picking the models and telling them what to wear.
"The instructions were to wear black heels, short black skirts, white lab coats, and in some cases, colorful wigs, blue wigs, purple wigs," Boffetti said.
"Using models to try and get people to sign up — there's nothing wrong with that. The problem is if they're overcharging insurance companies and if they are not properly advising potential donors," he said.
The UMass Memorial lab, based in Worcester, may have spent as much as $4 million on the models over the past 18 months, Boffetti said. The Boston modeling agency hired by the lab was paid $40,000 to $50,000 per week.
The models were paid $75 an hour to approach people in shopping malls in Massachusetts and New Hampshire. They also set up shop at the Boston Marathon and at Red Sox and New England Patriots games, Boffetti said.
The models typically would approach people, then bring them to a kiosk where workers from the Caitlin Raymond International Registry — a subsidiary of UMass Memorial — would do a cheek swab. The donors were told the tests cost about $100 and would be paid for by their insurance companies.
New Hampshire officials began investigating after the mayor of Manchester reported that two employees covered by the city's medical insurance said their explanation of benefits statements showed a combined charge of $8,400. A spokesman for Massachusetts Attorney General Martha Coakley said her office is also reviewing the practices of the lab and the bone marrow registry.
In a statement, UMass Memorial and the Caitlin Raymond registry, which has more than 185,000 donors throughout New England, said they have voluntarily suspended donor recruitment efforts in New Hampshire, discontinued use of the models and are cooperating with the Massachusetts and New Hampshire attorneys general.
"As part of the donor recruitment effort, UMass Memorial has used models to help acquaint the public on how they can contribute to this lifesaving effort before introducing a prospective donor to a member of the Caitlin Raymond staff," the statement said.
UMass Memorial said it is reviewing its billing practices for the test "to ensure that it is appropriately paid based on the negotiated rate in the contract between the respective insurance company and UMass Memorial."
Robert Brogna, a UMass Memorial spokesman, did not return calls requesting comment beyond the statement.
Although the charge to insurance companies has been listed as high as $4,336, most insurers pay amounts based on their negotiated contracts with UMass Memorial, between $700 and $1,500, Boffetti said. That's still higher than the cost of about $100 quoted to New Hampshire legislators when the state passed a law in 2006 mandating insurers to cover the bone marrow tests.
Boffetti said UMass Memorial has assured him that no donor will have to pay for the test.
Using models apparently worked to attract large numbers of donors.
Blue Cross Blue Shield of Massachusetts said it spoke to UMass Memorial after seeing a surge in its claims.
"They've assured us they plan to address our affordability concerns," said spokeswoman Tara Murray.
Murray said that while the insurer supports adding the names of people who want to donate bone marrow to registries, "we are concerned about the proliferation of service sites for these tests. We did not expect that these tests would be conducted in retail settings."
Michael Boo, chief strategy officer for the National Marrow Donor Program in Minneapolis, said he had never heard of hiring models to recruit donors.
"Certainly, our recruitment groups that work with us are always trying to find ways of bringing donors to the drive, but that was a little unusual," he said.
Boo said it's important for prospective donors to understand that by signing up for the registry, they've made a commitment to help a patient.
Judkins, 23, of Atkinson, N.H., said he thinks it's "absurd" to charge insurance companies $4,000 for the test.
"If people are going to donate, that money should be spent on research ... to spend it on a model to try to draw people in, that kind of nullifies the point," he said.