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  • Urine Drug Testing required by law?

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    Old 07-24-2018, 07:30 PM   #1
    coback's Avatar
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    Urine Drug Testing required by law?

    I am still struggling with back pain (since May 2000). I took Oxycontin for nearly 16 years and I might of had a UDT once or twice in all that time. My doctor sent me to pain management and they are testing me all of the time. When I questioned them about it, they told me they were required by state and federal law to test me randomly 6-9 times a year. So I went home and have tried to do a search for these laws but I can't find them.

    My insurance company won't pay for them claiming they aren't medically necessary and the drug testing place is charging me $1500 a test!

    So I guess I am asking you guys if there are such laws or not.

    Lisa in CO

    1993 - anterior & posterior fusion L2 - S1
    2003 - posterior fusion T10 - L2

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    Old 07-24-2018, 11:24 PM   #2
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    Re: Urine Drug Testing required by law?

    You could try looking up your state drug testing laws for the beginning of 2018. I use a primary care physician and I'm urine tested every month. You can also ask your insurance about their preferred lab(s), then passing on the info to pain mngmnt and ask if it's possible to use your insurance's preferred lab.

    I sympathize about those lab charges. They are HIGH. It wouldn't hurt to call them, explain your insurance ask for reduced rates, as well as an ITEMIZATION of what you're being tested for. By law, that IS your right.

    Old 07-25-2018, 05:43 AM   #3
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    Re: Urine Drug Testing required by law?

    The frequency of testing is typically left to the practice. As far as I am aware, it must be done once a year, but some practices do it more frequently, especially with new patients, or those on higher doses. In some cases they may do it more frequently for the first year or so, then provided everything is fine, may reduce the number of testings.

    Old 07-25-2018, 08:15 PM   #4
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    Re: Urine Drug Testing required by law?

    So sorry you are having to deal with this. I do not think there is a "law", unless possibly your state has one. However, there are guidelines that doctors have been asked to follow, or else put their license/practice at risk, such as the ones the CDC put out. They are getting pressure from all sides to follow them. I know those guidelines include UAs, but I'm not sure if they specify a certain required frequency. I have heard of doctors saying it is a law, likely to more easily explain it / not have patients question it. Unfortunately we are at the mercy of our doctors, and to continue getting pain meds, we must do as they request.

    The frequency may decrease over time, or else that could just be their practice for all patients, or at least all patients on your type of med/s and/or or dose/s. For what its worth, I get tested exactly every 24 weeks it seems (I go in every 4 weeks), although they say it is random. I've been with the same pain doctor about 7 years, on the same med combo for most of it, and on a lower dose than I started at (I got a big increase when I first started there as I was doing poorly, then they reduced it by 2/3 a few years ago as they said they could no longer prescribe that much, no matter my pain levels).

    I think all of us still getting opioids for chronic pain right now are lucky, and that they will continue to get less commonly prescribed, even for those of us who have done well on them long term and who have failed all other treatments. It seems like doctors are getting scared out of prescribing opioids. I have heard of so many places getting shut down, or doctors deciding on their own to close up shop.

    If its that high of a cost it means they are running a GC/MS. This is in the best interest of the patient and doctor, as it will tell the levels in your system, not just positive or negative, and way more accurate, although a much higher cost.

    Have you actually got a bill for that amount? I received an Explanation of Benefits from my insurance for one of those years ago and started to freak out, as it said my insurance denied it, so I assumed that meant I owed that amount. However, I talked to my doctor's office and they said they had an agreement with the lab that patients did not need to pay anything beyond what insurance covered (if anything). I have never received a bill for any UA.

    So, check with your doctor's office and/or the lab to see if you are actually responsible for what they do not cover. If they are actually billing you, then exhaust all appeals with the insurance company (there is more than 1 level of appeal by the way). If that fails, negotiate. Insurance would not pay the full list price, and you should not need to either if you were paying cash. Also, talk to your doctor. Many doctors don't even know how much patients end up paying for tests they request, meds they prescribe, etc, and are surprised when they are told, and reconsider. There may be alternatives. As this is a pain doctor/clinic, I'm sure they have other patients who they are testing, and at least some of them must have insurance which denies these as not medically necessary. Hopefully they have some process in place for that situation.

    If all that fails, then you may have a tough decision to make as far as if you can afford the UAs to be able to get the opioids you need. Do know however that it is current very standard practice to have to get them, it is just the frequency that varies, and possibly the type. My doctor doesn't run a full GC/MS every time; usually they just do the cheap read from a cup type that costs maybe $20. I think they only did the GC/MS the first time, and if the cup type has any unexpected results. Hang in there! Best wishes.
    constant headache since 2006

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