Florida Lab, Execs Settle False Billing of Urine Drug Test Charges for $41 Million
Case: Prosecutors accused a Tampa reference lab, pain clinic and two former executives of billing Medicare, Medicaid and TRICARE for medically unnecessary presumptive and definitive Urine Drug Testing (UDT). The defendants denied the charges but decided to pay $41 million to settle rather than risk a trial. Significance: Presumptive UDT screens for the presence of drugs, while definitive UDT identifies how much of the drug is in a patient’s system. The latter are medically necessary only when presumptive screening produces a positive result. But the feds claim the lab and clinic routinely and automatically ordering both kinds of testing for all patients at every visit, without having a physician make an individualized determination of whether either test was medically necessary for that particular patient.
Case: Prosecutors accused a Tampa reference lab, pain clinic and two former executives of billing Medicare, Medicaid and TRICARE for medically unnecessary presumptive and definitive Urine Drug Testing (UDT). The defendants denied the charges but decided to pay $41 million to settle rather than risk a trial.
Significance: Presumptive UDT screens for the presence of drugs, while definitive UDT identifies how much of the drug is in a patient’s system. The latter are medically necessary only when presumptive screening produces a positive result. But the feds claim the lab and clinic routinely and automatically ordering both kinds of testing for all patients at every visit, without having a physician make an individualized determination of whether either test was medically necessary for that particular patient.
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