How Opioid Patients' Urine Became 'Liquid Gold'

Urine tests have gotten sophisticated, and some pain doctors have gotten rich
By Kate Seamons,  Newser Staff
Posted Nov 6, 2017 1:10 PM CST
The Opioid Epidemic Has a Quiet Side Hustle in Urine
Urine samples are shown in this stock photo.   (Getty Images/lkordela)

The article calls it "liquid gold," and that might be only a slight exaggeration. A lengthy piece by Fred Schulte and Elizabeth Lucas for the non-profit Kaiser Health News that was picked up by Bloomberg examines a side business that has sprung up alongside the opioid epidemic: pricey and sophisticated urine drug screens that purport to verify the prescribed pills are being taken properly. Their predecessor was a simple one: a $10 cup a patient pees into that contains a test strip that can signal the presence of any of 10 or so drugs. But some labs started upping the fees charged, so the Centers for Medicare & Medicaid Services instituted a change in early 2010 to clamp down on this. Instead, a pricier industry was born, in which some pain doctors started ordering more-involved tests that are analyzed via machine—in some cases in labs run by these same doctors.

The kicker: When a machine is involved, every test for every drug can be billed to Medicare individually. According to the Kaiser Health News analysis, that's led to a spike in urine screens that specifically test for, say, the street drug PCP, though it says that drug is found in less than 1% of tests. And it's also led to this: "The federal government paid providers more to conduct urine drug tests in 2014 than it spent on the four most recommended cancer screenings combined." Some pain doctors who run their own labs have profited heartily; other doctors have apparently been convinced that ordering frequent tests and sending them to outside labs will lower their own liability. Medicare did start getting tougher on billings for these tests in 2016, but there doesn't yet exist a definitive national standard regarding who to test and how often. Read the full story here. (More opioids stories.)

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