Urine tests have become an almost humdrum part of applying for a job as hopeful applicants try to prove to employers that they're addiction-free.
Processing all those urine samples has become a lucrative business, as Kaiser Health News and the Mayo Clinic researchers report spending quadrupled from 2011 to 2014 to about $8.5 billion yearly.
For comparison's sake, PBS pointed out the Environmental Protection Agency's entire budget for 2017 was $8 billion.
"There are virtually no national standards regarding who gets tested, for which drugs and how often. Medicare has spent tens of millions of dollars on tests to detect drugs that presented minimal abuse danger for most patients," PBS reports, adding that tests for street drugs like cocaine, PCP and ecstasy seldom return positive.
A federal official told PBS it's a red flag signaling overuse that many pain-management practitioners earn 80 percent or more of their Medicare income from urine testing.
“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.”
To circumvent new rules limiting huge charges for simple urine screens, the report alleges some doctors have nixed those standard cup tests for specialized (and costlier) testing that could bill each drug test individually under Medicare rules.
“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 longtime lab industry consultant whose company, CodeMap, has tracked the rise of testing labs in doctors’ offices.
Medicare started cracking down on urine billings in 2016, PBS reports, and Mehta said clinics that adopt a “one-size-fits-all” approach to urine testing may find themselves under investigation.
That's something the Comprehensive Pain Specialists lab told PBS they would work to "play by the rules of the game."
“Tell us how often to test,” said Chief Operations Officer Jeff Hurst, “and we’ll be happy to follow it.”
Read the full investigation on PBS' website here.