Home 5 Lab Industry Advisor 5 Essential 5 Scorecard: SVT False Billing Settlements Near the $3 Million Mark

Scorecard: SVT False Billing Settlements Near the $3 Million Mark

by | Mar 9, 2020 | Essential, False Claims-lca, Lab Compliance Advisor, Reimbursement-lca

Urine drug testing for purposes of medical treatment is deemed medically necessary under Medicare billing and payment rules. The same is not true for specimen validity tests (SVT), a quality control process designed to catch drug test cheaters by verifying that a urine drug screen sample is consistent with normal human urine and hasn’t been adulterated, diluted or substituted. In February 2018, the OIG issued a report contending that Medicare made $66.3 million in improper SVT payments to nearly 4,500 labs and physician offices. In response, CMS ordered Medicare contractors to take measures to get that money back. Since then, at least 10 different urine drug testing labs, most of them from the Ohio Valley, have come forward to self-disclose improper SVT billing, generating over $2.8 million in total recoveries. Here’s the settlement rundown as of the end of 2019. Urine Drug Testing Lab SVT Billing Settlements in 2019 Date Lab Settlement Amount Jan. 24 Northern Kentucky Center for Pain Relief $126,799 Feb. 6 Wheelersburg Internal Medicine Group + Mohammad Mouhib Kalo, MD (Ohio) $111,706 March 13 VerraLab JA, LLC (Louisville, KY) $125,983 March 13 Medical Specialist of Kentuckiana, PLLC (Louisville, KY) $69,776 May 30 Commonwealth Pain Associates, PLLC (Louisville, […]

Urine drug testing for purposes of medical treatment is deemed medically necessary under Medicare billing and payment rules. The same is not true for specimen validity tests (SVT), a quality control process designed to catch drug test cheaters by verifying that a urine drug screen sample is consistent with normal human urine and hasn’t been adulterated, diluted or substituted. In February 2018, the OIG issued a report contending that Medicare made $66.3 million in improper SVT payments to nearly 4,500 labs and physician offices. In response, CMS ordered Medicare contractors to take measures to get that money back. Since then, at least 10 different urine drug testing labs, most of them from the Ohio Valley, have come forward to self-disclose improper SVT billing, generating over $2.8 million in total recoveries. Here’s the settlement rundown as of the end of 2019. Urine Drug Testing Lab SVT Billing Settlements in 2019
Date Lab Settlement Amount
Jan. 24 Northern Kentucky Center for Pain Relief $126,799
Feb. 6 Wheelersburg Internal Medicine Group + Mohammad Mouhib Kalo, MD (Ohio) $111,706
March 13 VerraLab JA, LLC (Louisville, KY) $125,983
March 13 Medical Specialist of Kentuckiana, PLLC (Louisville, KY) $69,776
May 30 Commonwealth Pain Associates, PLLC (Louisville, KY) $88,214
June 28 Ethos Laboratory (Newport, KY) $1,345,959
Aug. 7 Discover Diagnostic Laboratory, LLC (Oak Ridge, TN) $95,882
Aug. 22 American Clinical Solutions, LLC (Boca Raton, FL) $61,546
Oct. 4 Ohio River Laboratories, LLC (Houston, TX) $49,493
Dec. 12 American Toxicology Lab, LLC (Johnson City, TN) $175,889

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