Incentives matter: after back surgery, a routine urine test resulted in a $17,800 bill the patient was expected to pay


At a followup visit a year after Elizabeth Moreno had a disk removed to successfully treat her crippling pain, her doctor asked her to leave a urine sample; a few months later, Sunset Labs LLC of Houston sent her a bill for $17,800.

Moreno's doctor had seemingly ordered the urine test to ensure that she hadn't abused her post-operative opioid pain medication, but he didn't just order tests for opioids: he also asked the lab to check for indicators of "cocaine, methadone, anti-anxiety drugs and several other drugs she had never heard of" including amphetamines and PCP.


Those unnecessary tests could certainly raise the price on a simple urine test, but it gets worse because of Sunset Labs' crazy price-gouging: the amphetamine test was $1,700 and the PCP test was $425. The lab also charged an eye-popping $850 for a pair of simple tests meant to detect tampering with the sample.

Blue Shield refused to pay the bill, and also advised Moreno that in their opinion, the services rendered were worth about $100, not $17,800.

As doctors have become more cautious about opioid addiction, the use of routine urine drug tests has increased. This has led to a bonanza for sleazy, price-gouging testing labs, who are on the receiving end of a golden shower of riches.

Moreno's father is an MD; he settled with the lab for $5,000 and filed a complaint with the Texas AG for "price gouging of staggering proportions."


How a urine test after back surgery triggered a $17,800 bill [Fred Schulte/Kaiser Health News]


(via Naked Capitalism)


(Image: Mario Hains, CC-BY-SA)