Advocacy campaign to fight reimbursement cuts for POC urine drug screen devices

Sep 9 2009

Millennium Laboratories, a leading provider of therapeutic drug monitoring and education to physicians and staff treating chronic pain patients, has announced the launch of an advocacy campaign to fight reimbursement cuts to point-of-care (POC) urine drug screen devices. Millennium will be presenting a solution to the Centers for Medicare and Medicaid Services (CMS) on September 10, 2009.

Millennium Laboratories’ proposed solution has three-fold benefits to Medicare, physicians, their pain patients, and to society. The solution will:

• Save Medicare dollars by moderating reimbursement rather than eliminating it.
• Retain POC urine drug screening as a critical diagnostic tool for physicians.
• Help protect patients and the public from the harmful consequences of prescription drug abuse.

Current Situation of Concern

Presently, a proposal is before CMS to drastically cut reimbursement for point-of-care test (POCT) devices used in urine drug screening. Outside interests are proposing these drastic cuts to CMS based on the premise that physicians should not bill CMS for multiple drug tests when doing in-office urine analysis. If only it were that simple.

Controlled prescription drug diversion and abuse cost public and private health insurers $72.5 billion per year, much of which is passed to consumers through higher health insurance premiums (2009 National Prescription Drug Threat Assessment – Drug Enforcement Agency). The White House Office of Management and Budget estimates that, including crime, loss of productivity and government anti-drug programs, the cost is $300 billion a year.

Physicians have few tools at their disposal for early detection of illicit drug use and drug diversion in patients. By limiting the physician’s reimbursement to conduct POCT to levels which are three to four times below their cost, the effect is disastrous. Millennium’s proposal is to moderate reimbursement rates to a level that allows physicians to retain the tool and properly cover their costs.

Early drug abuse intervention techniques reduce patient morbidity and mortality and decrease overall costs to society. POCTs also assist physicians who may under-prescribe legitimate medications for chronic pain patients because they fear the Drug Enforcement Agency’s (DEA) scrutiny and reprisal. POCTs are tools which achieve a balance between preventing drug abuse and diversion and maintaining proper levels of pain control for patients.

First Line of Defense against Drug Abuse: POCTs Save Lives

James Slattery, CEO of Millennium Laboratories, said, “As a former police officer I witnessed first hand the pain and destruction drug abuse has had on individuals, families, communities and our society. In 2007, I founded Millennium Laboratories to play a broader role in stemming the tide of prescription drug abuse, addiction and diversion.”

Millennium Laboratories and coalition supporters maintain that POCTs are the first line of defense in identifying illicit and prescription drug abusers. If POCTs are not used by doctors who prescribe pain medications, many abusers, illicit drug users, and drug diverters will go undetected. This will cause an increase in deaths from prescription medications. In 2006 alone, 93% of unintentional overdose deaths involved non-medical use of prescription drugs (White House Office of Management and Budget). The discontinuation of judicious use of POCTs will also lower the standard of care for legitimate pain patients.

With the degree of drug morbidity and mortality that exists, Millennium contends it is unconscionable to adopt changes that will reduce surveillance when the welfare of society demands increased identification of undisclosed drugs.

Pain management expert Dr. Lora L. Brown, immediate Past President of the Florida Society of Interventional Pain Physicians and a pain physician with Coastal Pain Management and Rehabilitation, commented, “The POC test is so critical for objective, on-the-spot information for the pain specialist, that its removal would place countless patients and society in jeopardy. The utility of POC testing in the management of patients on controlled substances has never before been questioned. I firmly believe that developing a middle ground for cost containment will serve everyone's desires to protect our patients.”

Solution that Addresses the Full Issues

Millennium Laboratories is presenting to the CMS an inclusive, medically ethical and financially sound solution that will reduce reimbursement for POCT devices to an amount that represents Medicare savings, and at the same time keeps the reimbursement at a level that makes it financially viable for physicians to use POCT devices.