Pain Doctors Are Making Millions Off Urine Tests, Report Says

By Kelly Burch 11/14/17

Doctors are ordering urine screens with alarming frequency and banking the profits. 

Medical report and urine test strips

Pain doctors are making million of dollars by ordering urine tests that are unnecessary and over-used, according to a new report. 

"Doctor, drug testing is not about medicine but about making money, and I am going to show you how to make a lot of money," one lab representative said during sales calls later exposed in an affidavit.

Kaiser Health News, along with researchers at The Mayo Clinic, found that urine testing among pain patients has become a lucrative business for doctors. Medicaid reportedly paid one doctor-owned lab company, Comprehensive Pain Specialists, $11 million for urine tests and other lab work related to them during 2014. One nurse practitioner with the company reportedly billed Medicare for $1.1 million worth of tests that year. 

Overall, the report found that spending on urine analysis and related tests quadrupled between 2011 and 2014, reaching a stunning $8.5 billion a year. The Kaiser report found that the federal government, paying through Medicaid and Medicare, spent more on urine analysis than it did on the four more common cancer screenings combined in 2014. 

Proponents of urine testing say it is necessary for prescribers to know what drugs are in a patient’s system, from legally prescribed opioids to street drugs like cocaine. However, Kaiser reports that doctors regularly test for drugs that are found fewer than 1% of the time, adding a huge expense to an already overburdened medical system. 

Thirty-one pain doctors around the country got more than 80% of their Medicare income just from urine testing. Opponents say this clearly demonstrates that something is wrong with the system. 

“We’re focused on the fact that many physicians are making more money on testing than treating patients,” said Jason Mehta, an assistant U.S. attorney in Jacksonville, Florida. “It is troubling to see providers test everyone for every class of drugs every time they come in.”

Federal authorities with the Centers for Medicare & Medicaid Services found in 2010 that doctors were overcharging for simple urine drug screens that cost about $10 to conduct. In response, some doctors began ordering more sophisticated tests that require specialized lab machines, often found at labs that the doctors have a stake in.

Using these machines rather than charging insurance for one strip that detects up to 10 drugs, labs could charge for each drug screening individually. 

“It was almost a license to steal. You had such a lucrative possibility, it was very tempting to sell as many [tests] as you can,” said Charles Root, a lab industry consultant.

William Wagner, a pain specialist who briefly worked for Comprehensive Pain Specialists but is now suing the company, said that the testing practices are based solely on making a profit. 

“All of their money was being made off of urine drug screens. They weren’t doing anything else properly,” he said.

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.