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Bill bans kickbacks in urine-testing

In Florida, where drug-testing is a growth industry, the rush for market share in urine has led some companies to pay doctors for the right to grab the cups as soon as they’re filled. 

The Agency for Health Care Administration has tried to stop the practice, saying it amounts to an illegal kickback. But laboratory companies have contested that, even taking AHCA to court, saying the statute doesn't spell that out.

Under bills that the full House and a Senate committee will hear today, the state spells it out: When a company directly or indirectly pays doctors or clinics for exclusive rights to collect and test urine, that's illegal.

 It doesn’t matter what the lab company calls the payment.  For example, some companies have paid "rent" for the space in which a collection agent operates, while others have provided a receptionist to help staff the front desk at a busy clinic.

A year ago, Health News Floridareported that urine tests had become a hot commodity, a kind of liquid gold. Busy pain-management practices required patients to provide urine samples to assure they were taking only the narcotics prescribed for them, and that patients were actually swallowing the pills, not selling them. 

When some of the major companies continued placing urine-collectors in doctor's office and paying for the privilege, AHCA tried to crack down. In August, it issued a clarification letter to laboratory directors explaining in detail what was not allowed.

But the statute doesn't define what constitutes a kickback and AHCA's own definition is under legal assault, according to a staff analysis of the House bill.

So the bill amends the statute to provide that a clinical laboratory may not provide personnel to perform any functions or duties in a physician's office for any purpose unless the lab and physician's office are owned and operated by the same company.

The bill requires AHCA to investigate all complaints about potential violations and impose a fine of $5,000 for each one.  If the fine is $5,000 per sample, that could add up.

The clinical-lab language constitutes only a small part of a massive bill that addresses many facets of AHCA regulations. The House bill is HB 1419; the Senate version, CS/SB 1884, will be before the Senate Health and Human Services Budget Committee.

--Health News Florida is an independent online publication dedicated to public-service journalism. Editor Carol Gentry can be reached at 727-410-3266 or by e-mail.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.