The U.S. Attorney’s Office for the Western District of Michigan announced today that Physicians Toxicology Laboratory, LLC (PTL), based in Tampa, Florida, has agreed to pay $4.4 million to resolve allegations of violating the False Claims Act.
According to the department, PTL allegedly caused physicians to order medically unnecessary urine drug testing (UDT) and hormone testing, submitting claims for Medicare reimbursement for those tests.
The department stated that PTL provided laboratory services for several Michigan medical practices, which routinely ordered two types of UDTs: presumptive and definitive.
A presumptive UDT is an initial test that detects the presence or absence of substances in the body, the department explained.
Definitive UDTs are more advanced tests that identify individual drugs, distinguish structural isomers, and measure drug concentrations at nanograms per milliliter.
The department emphasized that Medicare requires UDT claims to be based on an individualized determination for each patient and does not cover “blanket” orders for such tests.