Medicare on drugs: 24,000 tests for 145 patients

Medicare on drugs: 24,000 tests for 145 patients

Three Connecticut doctors billed Medicare for nearly 24,000 drug tests in 2012 – on just 145 patients. Despite the extraordinary number, Medicare administrators paid the doctors a total of $1.4 million. … they ordered so many individual tests, their patients averaged one every other day.

A surge in prescription drug abuse among older Americans has been accompanied by a big increase in urine and blood tests nationwide. Part of an effort to detect that abuse, the tests generate millions of dollars for providers. Medicare, the government insurance system for the disabled and people 65 years and older, is footing the bill.

For those without Medicare, many of these tests are not covered by regular health insurance, and they have to pay out of pocket.  Pain patients are subjected to more financial shakedowns by more intermediaries each time another level of restrictions is added to our opioid access.

experts in laboratory billing said the high frequency of tests was extremely unusual and underscored the need for Medicare to improve oversight of potentially lucrative drug tests to guard against billing for unnecessary procedures.

There seems to be little sympathy for patients that are being coerced to give up their privacy and their money to keep their access to a medically necessary medication.

“There is no medical indication I can think of that would require such frequency of testing. I can’t come up with a scenario at all.”

Each of the doctors requested only the most expensive and comprehensive drug test, for as much as $94, rather than the simpler $19 one. This was done to improve the accuracy of the results, one said.

SPIGOT OF MONEY

Medicare paid medical providers $457 million in 2012 for 16 million tests to detect everything from prescription narcotics to cocaine and heroin

In some parts of the country every doctor and his cousin is hanging out a shingle to do (addiction) treatment. There’s a tailor-made opportunity for ordering a profusion of tests instead of one,”

Presumably, when a patient “fails” such a drug test, they can then be sent on to the next fleecing: addiction treatment. These treatment centers are popping up everywhere because they are so profitable, require little experience, education, or certification, and receive little oversight.

A “treatment facility” can be set up by anyone with enough money and, once running, can do no wrong in the eyes of the public, only confirming their belief that everyone taking opiates is an addict.

Urine and blood tests are potential areas of fraud and abuse because guidelines for drug testing are vague, leaving the frequency of testing to the discretion of the provider.

This complete lack of concrete numbers or specific direction would never be tolerated in any other field of medical care.

Addiction medicine is a wide open frontier right now and everyone is trying to get in on the land-grab. This exploding field has no standards, few rules, and is being defined and manipulated by financial interests, not medical experience or scientific study.

Addiction psychiatrist Erum Shahab of Ellington conducted 8,518 drug tests for 43 Medicare patients in 2012, the Reuters analysis found. That’s an average of 198 per patient and the most of any Medicare provider in 2012.

DECIPHERING BILLS

Ninety-five percent of her Medicare revenue came from the tests.

New London-based Dr Bassam Awwa, who also specializes in treating addiction, conducted 13,260 drug tests for 90 patients in 2012, or 147 per patient.

Dr Ammar Traboulsi, who shares an office with Awwa, was paid for 2,142 drug tests on 12 patients in 2012, or an average 178 tests per patient.

Among the thousands of providers who charged Medicare for drug tests, the next highest number of tests per patient in 2012 was 50. Excluding the three Connecticut doctors, the median number per patient nationwide was 1.3.

some physicians may be ordering tests on the vast majority of their patients, even those with no history of abuse.  

It seems odd that this, the most obvious conclusion, is only casually mentioned toward the end of the article, almost as an aside.

Also See:  Drug Testing for Painkillers Motivated by Profit, and Drug Testing Can Make Doctors Rich

7 thoughts on “Medicare on drugs: 24,000 tests for 145 patients

  1. painkills2

    “A surge in prescription drug abuse among older Americans has been accompanied by a big increase in urine and blood tests nationwide.”

    Sure, if you look at statistics over the period of a decade, you will see a rise in prescriptions, along with abuse, in the ever-growing senior population. But there is not an epidemic in this group — seniors are the least likely to abuse their medications. After all, medications are expensive.

    As for the addiction medicine and rehabilitation industry — mostly, just a scam.

    Liked by 1 person

    Reply
  2. Payne Hertz

    Doctors and hospitals defraud Medicare of over $60 billion a year, so this is but one of many scams that are pulled on Medicare patients and the government. I have never seen a breakdown of how much price gouging adds to overall costs, since it is often not considered “fraud” but the wonders of the “free market” in action. In the 19th Century when opiates were sold over the counter in local stores a bottle of laudanum cost less than half a day’s pay for a laborer. Prohibition was set up as a price support to drive the cost of opiates to their current stratospheric levels. The insane and indecipherable rules around Medicare durable equipment seem almost tailor-made to enable fraud.

    http://www.washingtonpost.com/new-medicare-rule-aims-to-curb-waste-and-fraud-in-medical-equipment-business/2012/03/20/gIQARa0iYS_story.html

    Estimates of overall fraud in the system vary wildly with some being as high as $600 billion.

    http://www.npr.org/templates/story/story.php?storyId=111967435

    This whole system is a kleptocratic scam, yet many are convinced it is government’s weak oversight of this mess that is the cause of the problem and we just need to restore the alleged “sacred bond” between doctors and patients by letting the system do whatever the hell it wants to us.

    Liked by 2 people

    Reply
  3. starwood500

    At 58 despite 10 years in pain management without a failed drug screen or any lost prescriptions I am tested every 3 months. And tested for everything. I received a bill for$1400 for one test. Tennessee is encouraging this practice in their pain medication requirements. Not to mention that I am not allowed to wash my hands before handing over the urine-doorknobs-or flush the commode for some reason. There is no way that I could pay for these tests on my limited disability check.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      It’s appalling that we’re expected to pay for tests we don’t even need.

      Unfortunately, we are always under threat of losing all pain treatment if we don’t jump through whatever hoops they ask us to. It’s blatant coercion – someday people will look back on this and be disgusted with the way pain patients are treated these days.

      Liked by 1 person

      Reply
  4. Pingback: Doctor Defends Use of Urine Drug Tests | EDS Info (Ehlers-Danlos Syndrome)

  5. Pingback: Patients “Fired” for Misinterpreted Urine Drug Tests | EDS Info (Ehlers-Danlos Syndrome)

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