Drug Testing Case Settles for $7.4 Million

A Florida clinic has settled a False Claims Act case relating to drug testing for $7.4 million. Quantitative drug tests that count illicit drug particles in urine are rarer and more expensive than qualitative tests that simply detect the drug’s presence. So when data analytics showed that a Florida pain clinic was a statistical outlier for Medicare billing of quantitative tests, federal investigators swooped in. The DOJ filed False Claims Act charges, claiming the clinic did quantitative tests on elderly patients routinely, regardless of medical necessity, even when patients’ qualitative tests came back negative.

This settlement is the latest in a series of enforcement actions for false billing of medically unnecessary urine drug screening tests:

• On Aug. 18, two former lab professionals convicted at trial of such charges were sentenced to 36 months in prison and ordered to pay $1.437 million in restitution; and
• Similar charges were among the allegations of a pair of whistleblowers settled by PremierTox 2.0, Inc. for $2.5 million in April.

[Physicians Group Services, P.A., dba Coastal Spine and Pain, USAO, M.D. Fla., Aug. 31, 2016].

For further discussion of recent enforcement efforts regarding reimbursement for drug testing, see “Drug Testing Enforcement Cases Lead to Costly Settlements and Convictions,” on page 1 of the May 2016 issue of G2 Compliance Advisor.