Pacific Toxicology Laboratories has agreed to pay $1 million to resolve allegations of submitting false claims for payment to Medicare for urine drug testing, according to the U.S. Attorney's Office for the District of Massachusetts.
Under the settlement agreement, Chatsworth, CA-based Pacific Toxicology admitted that between January 1, 2020, and March 14, 2023, it separately billed Medicare for confirmatory urine drug testing, in addition to the bundled payment rate applicable under Medicare regulations. The U.S. Department of Justice alleges that this practice of separately billing for urine drug testing for patients in opioid treatment programs resulted in Medicare paying twice for testing for some patients.
Medicare has established a bundled payment rate for the services that opioid treatment programs provide for patients with opioid use disorder, which includes urine drug testing. Therefore, Medicare makes one all-inclusive payment for all treatment services for a patient in these programs.
The claims resolved by the agreement were brought under the whistleblower provisions of the False Claims Act; as part of the resolution, the whistleblower will receive approximately $200,000.
