U.S. Doctors Charging Medicare Millions for Senior Drug Testing

Introduction

A San Diego company, Millennium Laboratories, was paid $190 million from Medicare in 2012 including $4.5 million for PCP tests, more than any other California company.

Main Item

"Testing seniors for PCP and ecstasy is a comic but all too common example of skyrocketing costs generated by doctors who order unnecessary but profitable tests and treatments," said Carmen Balber, executive director of Consumer Watchdog. "Doctors like to blame patients and lawsuits for the proliferation of unnecessary tests and procedures, but the truth is that more tests mean more revenue."

The Wall Street Journal analysis of payment data found that Medicare spent $445 million in 2012 on high-tech tests for drugs, up 1,423% in five years.

The WSJ analyzed 2012 Medicare billing data and found that dozens of pain management doctors were making more money from Medicare payments for drug testing than from treating patients. A New York Times analysis earlier this year found that just two percent of doctors receiving Medicare payments received 25% - or $15 billion - of all Medicare payments.

A 2012 analysis by former Centers for Medicare and Medicaid Services (CMS) administrator Donald M. Berwick and Andrew D. Hackbarth of RAND estimated unnecessary treatment costs the nation $158 to $226 billion a year.

Since Medicare cracked down on abusive billing practices for simple urine tests four years ago, doctors began to use higher-tech drug tests that are far more profitable. Medical experts have said that these more expensive higher-tech drug tests should only be used to confirm results from cheaper, lower-tech options.

Use of illegal drugs like heroin, cocaine, and marijuana is extremely rare among seniors. According to a 2012 survey by the federal Substance Abuse and Mental Health Services Administration, only about one in 1,000 seniors abuse or are addicted to illegal drugs. However, there remains an enormous profit-incentive for physicians to bill for unnecessary tests.

Wall Street Journal Report:

• online.wsj.com/articles/doctors-cash-in-on-drug-tests-for-seniors-and-medicare-pays-the-bill-1415676782

Wall Street Journal Analysis of 2012 Medicare Billing Data:

• projects.wsj.com/medicarebilling/

Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Consumer Watchdog and published on 2014/11/12, this content may have been edited for style, clarity, or brevity. For further details or clarifications, Consumer Watchdog can be contacted at consumerwatchdog.org NOTE: Disabled World does not provide any warranties or endorsements related to this article.