Evaluating motives: Two simple tests to identify and avoid entanglement in legally dubious urine drug testing schemes

This article educates healthcare practitioners on the legal framework prohibiting abusive practices in urine drug testing (UDT) in medical settings, discusses several profit-driven UDT schemes that have resulted in enforcement actions, and provides recommendations for best practices in UDT to comply with state and federal fraud and anti-kickback statutes.

The authors carefully reviewed and analyzed statutes, regulations, adivsory opinions, case law, court documents, articles from legal journals, and news articles.

Certain facts-driven UDT arrangements tend to violate federal and state healthcare laws and regulations, including Stark law, the anti-kickback statute, the criminal health care fraud statute, and the False Claims Act.

Healthcare practitioners who use UDT can help ensure that they are in compliance with applicable federal and state laws by evaluating whether their actions are motivated by providing proper care to their patients rather than by profits. They must avoid schemes that violate the spirit of the law while appearing to comply with the letter of the law. Such a simple self-evaluation of motive can reduce a practitioner's likelihood of civil fines and criminal liability.