# Masshealth spent more than $13.6 Million on unnecessary tests



## PPD54 (Apr 28, 2011)

An audit of the state's MassHealth program discovered more than $13.6 million in unnecessary expenses and improper billing of costs of drug testing for those treated for substance abuse.

The audit found the state's health care plan, which provides services to about 1.3 million low- and moderate-income residents, allowed and funded daily and sometimes twice-daily drug tests for some patients for as long as a year.

It also cited three laboratories for using an improper system of billing to overcharge a total of $4.5 million.

Auditor Suzanne M. Bump released the findings Tuesday with recommendations that laboratories pay back the money. Precision Testing Laboratories Inc. of Southbridge owes $3.5 million, Lab USA Inc., of Haverhill owes $751,430 and New England Pain Institute owes $194,034, the audit said.

In addition the University of Massachusetts Medical Center in Worcester has agreed to pay back $1.3 million for 23,882 drug tests it performed for sober homes, even though state law banned it from doing so, the report said.

UMass and Precision Testing officials did not return phone calls Tuesday.

The auditor's office has a standing unit that oversees expenses of MassHealth and the examination was part of the reviews, said Christopher Thompson, spokesman for the auditor's office.

"It is one of the most significant portions of our budget," he said about MassHealth.

Overall MassHealth paid medical providers more than $11.1 million in fiscal year 2011, with 40 percent paid by the commonwealth and 60 percent by the federal government. Expenses have increased by an average of 8.6 percent a year since 2007, the report said.

The cost of drug testing came to the attention of the auditor's office because of the sizable cost. In the last fiscal year MassHealth paid $18 million for more than 839,000 drug tests, the report said.

MassHealth does pay for drug tests ordered by a physician who is treating a patient for substance abuse but Bump said the testing was "excessive."

"Clearly millions of dollars has been spent on drug tests that have done little to help addicts in recovery but much to increase revenues for testing companies," Bump said in writing.

The audit found MassHealth could have saved $7.8 million by following federal guidelines that require far less testing. It took the agency to task for failing to monitor the frequency which patients were receiving tests, allowing duplicate tests that were unnecessary and ensuring testing was being done because of physician orders.

"Physicians and nurses...stated that they were pressured by laboratories and sober houses to sign orders requiring testing up to four times per week for residential monitoring. These clinicians also stated that if they did not sign the orders, their patients would be removed from sober housing or be directed to other physicians who would authorize the tests," the report said.

At the same time, Attorney General Martha Coakley is working with three state legislators to create a bill to close the loophole between drug testing labs and referral sources such as sober homes. The legislation was filed in January.

In some cases treatment programs also own the labs resulting in pressure for additional testing. The law will make it illegal for referrals, solicitation and testing of specimens when there is an ownership interest between the laboratory and the referral source, Coakley said in a written statement.

"These ownership arrangements have been identified as one of the largest health care fraud issues facing the state," the statement said.

The legislation and audit were started independently but the two offices did coordinate efforts, Thompson said.

http://www.masslive.com/news/index....rug_testing_cost_th.html#incart_river_default


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## Johnny Law (Aug 8, 2008)

Scumbag addicts


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## 263FPD (Oct 29, 2004)

OK soooo ready for this? 

I pay about 80-90 a week for family coverage to BCBS. Because of my oldest daughter's disability, we also have to carry MassHealth in this case MassCommonHealth coverage. When she was an only child, it cost us somewhere around 300/month. Since that time there were two more children, and the monthly premium did go down. Significantly. However, at times we still have wage war with them on the phone because they don't feel like covering this or that, and want reams and reams of paperwork and letters of medical necessity, before they give us any of the benefits that we pay dearly for. Then I get to read that SHIT above!!!!! WHAT THE FUCK!!!!


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## Mr Scribbles (Jul 7, 2012)

Pitchforks and torches! When is enough, enough?


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