The next revenue-generator for work comp profiteers

The next scam improvement in patient care and physician profits is…

in-office lab testing for drugs!!!  I’m not talking qualitative testing (the cup version) but rather tests done on a machine in a physician’s office. 

I received this email not once, but three times from a “consulting firm”.  I responded twice, intrigued by the opportunity to improve patient care AND generate more dollars for docs. I’m SURE insurers would be deeee-lighted to pay docs more for such wonderful improvements to patient care.

So, here’s the full text of the email.  Prepare to be amazed – there’s yet ANOTHER scam brewing in workers’ comp.

“We are a consulting firm that represents an innovative leader of in-clinic
drug screening solutions. Our client is seeking representation for its
toxicology offering for physicians who treat workers compensation patients.
Their testing options generate significant income for physicians and
representatives when testing workers compensation and commercial insurance
patients.

Like many ancillary offerings in medicine, Treatment Guidelines continually
evolve. Our client, unlike others, provides an automated portal into their
lab that is continually updated to keep physicians and related clinics
compliant. Their automated transactional software is considered best in
class in the industry and makes drug screening a snap. By providing
in-clinic testing solutions, physicians can now better manage patient
treatment regiments, generate significant additional revenue, mitigate
clinic liability and provide better patient care!

Our client is now reaching out to your organization to see if you are
perhaps interested in representing them in your local market. Our client
seeks reps that have direct/personal relationships with physicians.

— Reps now have the ability to add thousands of dollars per month to their
organization’s bottom line via these test offerings.

Benefits of Toxicology Testing for the Physician:
— Reduces Practice Liability.
— Prevents drug to drug interaction.
— Provides key information to better manage the treatment of patients.
— Generates additional clinic revenues with little to no out of pocket costs.
— Testing is simple, fast and easily compliments current daily clinic responsibilities.

The targeted Physician Practices/Clinics are:
— Any Physician that sees more than 10 or 15 new work comp patients per month
— Pain Management Centers
— Orthopedics
— Neuro Spine Surgeons
— Hand Surgeons
— Defense / Military suppliers
— Urgent Care
— Podiatry
— Specialists of Extremities
— Any Other Physician/Clinic that will benefit from administering toxicology testing.

If you are interested in representing this exciting best in class ancillary opportunity
in your local market, please call me or return by email your mailing address and
phone / fax number (or feel free to contact me directly). We are aggressively recruiting
reps in different local US markets and will immediately email you our client’s website
for your review. Please know that upon request, hard copy information can be sent
to you as well. We look forward to your response.”

What a great country.  Gotta love that free market!

16 thoughts on “The next revenue-generator for work comp profiteers

  1. We are a consulting firm that represents an innovative leader of in-clinic drug screening solutions.

    Joe, any idea who the ” innovative leader of in clinic drug screening” is?

  2. Hi Joe, First of all, Are you going to sign up? A great opportunity to branch out into a new field!

    I think we bring a lot of “opportunities” like these upon ourselves in the WC marketplace. With all the focus on Opioid overuse and abuse, this service makes perfect sense. Some of the best practices and treatment guides I see being developed in Opioid management require or highly suggest toxicology monitoring to make sure 1) there is no overdosing and 2) the patients are actually utilizing the drugs and maintaining the correct levels of dosage and not selling the scripts.

    Tox screeing will be the wave of the future for Opioid treatment – mandated by the WC regulators and industry through treatment guidelines. The question will be where should it be provided and at what reasonable cost?

    So is it worth the $$$ if it prevents a death or two due to overutilization of Opioids? The whole industry was aflutter with concern over Opioid deaths a couple months ago.

    Great post, thanks for sharing the development.
    -Brandon

    • Brandon – as always, it depends. Unfortunately there are myriad problems with in-office testing, quality and consistency being just two. Cost, abuse, and overuse are three other very significant ones.

  3. This has been happening for quite some time…. in CA with the IBR process change we have even seen IBR’s where pain management clinics are disputing and filing IBRs indicating their in office drug testing is “high complexity” testing.

    Palmetto put out an article a while back “Semi-Quantitative Drug Testing: Billing/Coding Alert” here is the link.. basically stating they cannot do nor bill for high complexity screening. During the 2010 Annual Public Meeting, CMS introduced HCPCS code G0434 to report qualitative point-of-care drug screen testing and to limit billing for such testing to one time per patient encounter. CMS also revised the descriptor for HCPCS code G0431 to emphasize that the code describes all screening for multiple drug classes per patient encounter. G0434 is for the dipstick, cassette, cups, cards, etc in the physician office, per patient encounter regardless of the # of drugs performed. G0431 is the high complexity test that laboratories perform.

    http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~Railroad%20Medicare~Articles~Drugs%20Biologicals~8Q2LHW8528?open&navmenu=%7C%7C

  4. What til you get a load out of this, I just this week rec’d a request for the following:

    “Non invasive DNA test for drug sensitivity otained and sent to lab for analysis…To identify the patients liver enyzyme genotype used to break down medications. This information will be usd to indentify the appropriate medications to be used to decrease the risj of adverse drug events, increase drug efficacy and improve compliance.”

    I have a feeling this is going to be a lot more prevalent in the SoCal WC claims industry…

    • we’ve seen a lot of the DNA testing as well… we can tell you if the person has the “addictive gene”….

      gotta lov’em for trying….

    • Jeff – indeed I do, as I’ve noted multiple times. Millennium is not an in-office lab company, unlike these scam artists.

      • Joe – you might want to check some of Millennium’s marketing materials. At least in the past their program has been a similar business model.

        • Debbie thanks for the note.

          Millennium has never put machines into physician offices. They do provide cups for qualitative testing but all quantitative testing is done at their labs in San Diego.

  5. Joe I do not believe you have your facts quite correct. Your client/sponsor Millennium sells more point of care drug testing supplies and equipment than any entity in the industry.

    Your opinion about the “deeee-light” of insurance companies to pay more for provider office drug testing is also in conflict with your client’s published position. “James Slattery, Millennium Laboratories founder and CEO, explained the company’s presence at the meeting. “We are advocating for a higher, though moderate, reimbursement level to physicians for performing drug screening tests……. It is simply the right thing to do for all parties involved.”SAN DIEGO, July 27 /PRNewswire

    go figure….

    • Jeff thanks for the note.

      The post referred specifically to companies providing IN OFFICE testing machines. Millennium does not do that. As you note Millennium is the largest toxicology testing firm.

      Regarding Mr Slattery’s comments, in fact, the payers who have contracted with Millennium have received significantly LOWER rates than fee schedule or UCR.

      In part that explains Millennium’s significant growth in workers comp. Their technology, service, field staff, and comprehensive testing panel are factors as well.

  6. Joe:

    I’m not going to get into Millennium. But I know that Toxicology screening doesn’t require anything but a dipstick, we just want to know if the patient is taking the drugs prescribed. If there is a problem, we can step it up to the higher level.

    The toxicology screening bills I see are generally over $1,500.00.

    I agree with the comment about DNA testing, that is the newest one and the one I’ve been marketed on a lot is for susceptibility to dependency.

  7. Glenda
    Thanks for the comment.

    Re qualitative screening, this is rife with false positives and negatives, does not identify the specific drug, and is far from comprehensive.

    Re bills, most companies bill at some multiple of Medicare. Check your next hospital bill for comparison; billing and expectations for collection are not connected.

    For example, check the data on cocaine. And the cup can’t tell if the opioid is OxyContin or another opioid.

    The cup is a collection tool and first line but is far from perfect.

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