Unauthorized lab work

[Bluto152]

What is the name of your state (only U.S. law)? FL
Seen a couple of similar threads here but my situation is slightly different. Under the care of my "in network" (HMO) doctor I was prescribed a controlled substance. Having just moved to Florida I had to find a new doctor obviously and was still under the COBRA coverage from my previous job. On the first appointment, I was told by the doctor's assistant that it was "Florida law" that I give a urine sample to verify that I was taking what I was prescribed (and presumably not selling it I guess). Being new to the state I did what I was told. I also naively thought that the urine samples were checked on site (assumed it was like a litmus test changes colors if it contains the looked for composition ... or something, I'm obviously not a doctor).

Well it's 4 months since I've seen that doctor being now on my new employer's plan which he wasn't in. But I just got a bill from the lab where he was apparently sending my urine samples to conduct complete toxicology screens. The lab was out of network (both new AND old). So it's over $2600.

Now, I have a couple of issues. 1) I have subsequently looked at Florida statutes and can't find anywhere a requirement to screen in this manner. In Title XLVI (Crimes) under Chapter 893 "Drug Abuse Prevention" it mentions a practitioner reporting requirement for some controlled substances database. But none of the required info resembles anything close to a tox screen result. Though I'm obviously not a lawyer either so might have missed it. 2) While my na�vet� on the nature of the urine testing might not be "reasonable" from some perspectives I'm not sure how I'm supposed to "be my own advocate" as has often strenuously been reinforced here in other threads if I have a false notion of the basic elements of the test/procedure (in this case that the sample was not being kept but rather sent off site). 3) regardless I am certain that it was presented to me as being a test JUST for what I was being prescribed. I've never heard of 80% of the long list of substances I was tested for and am now being charged for. 4) given that a tox screen is (I imagine) a common test, there would presumably be an easily accessible in-network lab that could perform it, no? At the very least a violation of the HMO contract if sent to an out of network lab when an im network was readily available.

All that being said, upon stumbling into the "tort" section of my statute review, how does conducting a test under what I believe to be under false pretenses, and certainly something I would never elect to do as it has nothing to do with treating me and is rather some sort of liability issue for others as far as I can tell, how does all of that not contradict the assumptions of both paragraphs a) and b) of 766.103 Florida Medical Consent Law 3.a.2 which requires knowledge and complicity from my reading. And if the circumstances contradict those paragraphs is that not grounds for malpractice?

Not really interested in taking this guy for all he's worth just to cover the bills of the test his staff lied to me about (from what I can tell) or else I would have refused to take it. What are my options, if any? And while I appreciate the "be your own advocate" advice, I'm not sure how one is supposed to "reasonably" navigate the Byzantine web of regulation, medicine, insurance and law that's been spun around us in order for us to determine what's even the right question to ask.

 

[Zigner]

I suggest that you make arrangements to pay the bill that you owe to the lab.

What is the name of your state (only U.S. law)? FL
Seen a couple of similar threads here but my situation is slightly different. Under the care of my "in network" (HMO) doctor I was prescribed a controlled substance. Having just moved to Florida I had to find a new doctor obviously and was still under the COBRA coverage from my previous job. On the first appointment, I was told by the doctor's assistant that it was "Florida law" that I give a urine sample to verify that I was taking what I was prescribed (and presumably not selling it I guess). Being new to the state I did what I was told. I also naively thought that the urine samples were checked on site (assumed it was like a litmus test changes colors if it contains the looked for composition ... or something, I'm obviously not a doctor).

Well it's 4 months since I've seen that doctor being now on my new employer's plan which he wasn't in. But I just got a bill from the lab where he was apparently sending my urine samples to conduct complete toxicology screens. The lab was out of network (both new AND old). So it's over $2600.

Now, I have a couple of issues. 1) I have subsequently looked at Florida statutes and can't find anywhere a requirement to screen in this manner. In Title XLVI (Crimes) under Chapter 893 "Drug Abuse Prevention" it mentions a practitioner reporting requirement for some controlled substances database. But none of the required info resembles anything close to a tox screen result. Though I'm obviously not a lawyer either so might have missed it. 2) While my na�vet� on the nature of the urine testing might not be "reasonable" from some perspectives I'm not sure how I'm supposed to "be my own advocate" as has often strenuously been reinforced here in other threads if I have a false notion of the basic elements of the test/procedure (in this case that the sample was not being kept but rather sent off site). 3) regardless I am certain that it was presented to me as being a test JUST for what I was being prescribed. I've never heard of 80% of the long list of substances I was tested for and am now being charged for. 4) given that a tox screen is (I imagine) a common test, there would presumably be an easily accessible in-network lab that could perform it, no? At the very least a violation of the HMO contract if sent to an out of network lab when an im network was readily available.

All that being said, upon stumbling into the "tort" section of my statute review, how does conducting a test under what I believe to be under false pretenses, and certainly something I would never elect to do as it has nothing to do with treating me and is rather some sort of liability issue for others as far as I can tell, how does all of that not contradict the assumptions of both paragraphs a) and b) of 766.103 Florida Medical Consent Law 3.a.2 which requires knowledge and complicity from my reading. And if the circumstances contradict those paragraphs is that not grounds for malpractice?

Not really interested in taking this guy for all he's worth just to cover the bills of the test his staff lied to me about (from what I can tell) or else I would have refused to take it. What are my options, if any? And while I appreciate the "be your own advocate" advice, I'm not sure how one is supposed to "reasonably" navigate the Byzantine web of regulation, medicine, insurance and law that's been spun around us in order for us to determine what's even the right question to ask.

 

[PaulMass]

Explain to the lab that these since these tests are required by law, that your insurance is required to pay for them, and that if they are not required by law, they should be seek reimbursement from the doctor who misrepresented that to you.

 

[ecmst12]

Have you tried contacting the doctor's office to ask them why they sent your test to an out of network lab and how they plan to handle the matter?

 

[Zigner]

Explain to the lab that these since these tests are required by law, that your insurance is required to pay for them, and that if they are not required by law, they should be seek reimbursement from the doctor who misrepresented that to you.

So, are you saying that insurance is required to pay? Or are you saying that insurance may be required to pay? You can't have it both ways. Furthermore, the lab has no reason to seek reimbursement from the doctor. The OP may have a cause of action against the doctor, but not the lab. The big hurdle here will be proof.

 

[OHRoadwarrior]

It is your job to make sure the tests are sent to an in network lab. FL has become very fastidious about the issuance of narcotics due to the incidence of street sales of prescription drugs. The logical thing to have done would have been to make sure it was in network or obtain a price on the testing beforehand. It appears you are now faced with your deductible for out of network providers. I suggest you call and see if they will negotiate a reduction based on the volume and your income.

 

[Bluto152]

I suggest that you make arrangements to pay the bill that you owe to the lab.

I've talked to the lab already and have made an initial payment to them, thanks. No other concerns I had are valid? So despite it being something I wouldn't have consented to, given its complete irrelevance to my personal well being, tough luck? Not sure why you thought this reply would be helpful.

 

[Zigner]

I've talked to the lab already and have made an initial payment to them, thanks. No other concerns I had are valid? So despite it being something I wouldn't have consented to, given its complete irrelevance to my personal well being, tough luck? Not sure why you thought this reply would be helpful.

Really? It was helpful because if you DON'T make arrangements to pay, they are going to ding your credit for this amount. It's not THEIR problem that you were not aware of your insurance coverage, nor is it THEIR problem that your doctor may have (or may not have) given you incorrect information. You may have recourse against the doctor, but I doubt it. Even if you do, it doesn't change your obligation to the lab.

 

[Bluto152]

Really? It was helpful because if you DON'T make arrangements to pay, they are going to ding your credit for this amount. It's not THEIR problem that you were not aware of your insurance coverage, nor is it THEIR problem that your doctor may have (or may not have) given you incorrect information. You may have recourse against the doctor, but I doubt it. Even if you do, it doesn't change your obligation to the lab.

The conceit you're bringing is in that I, as an adult, wouldn't know how credit scores work. I got that. I'm asking how I should approach getting said recourse against the doctor. Not looking for a lesson on fiscal responsibility.

 

[OHRoadwarrior]

The message all of us are trying to convey in one fashion or another is that you were so focused in the ball, you ran into a goal post. You should have verified the tests to be run, whether the tests run were going to be in network and if they were not, what the total cost would be. THEN, you should have peed in the cup. No one is happy you ran into the goal post. They are simply explaining you are the one who did and must suffer the pain for doing so. So you understand, my first pain mgmt drug screen of the year usually costs about $500 when run by a third party in network provider after adjusted to the contract rate, which I must pay in full. This year I switched offices and that office changed their protocol for testing, when they discovered the "non gov't" fees I was paying out of pocket. I still switched to another of their offices because that office billed a facility fee by the hospital which cost me $100 in addition to the $50 they billed for the visit.

 

[Ladyback1]

I've talked to the lab already and have made an initial payment to them, thanks. No other concerns I had are valid? So despite it being something I wouldn't have consented to, given its complete irrelevance to my personal well being, tough luck? Not sure why you thought this reply would be helpful.

a LOT of pain management Drs. will not treat a patient unless the patient UAs/Drug tests on request. (well, the competent pain mgmt docs do routine and random drug testing of pain management patients).

So, while it may not be a state law? It is still a standard and necessary part of a treatment plan. You would have probably had to do the test if you wanted the narcs...

 

[ecmst12]

However, if the doctor is in network, he may have a contractual obligation to make sure his office sends your tests to the correct in network lab. So I repeat - when you called the doctor's office to complain that they sent your test to the wrong lab, what did they say?

 

[Bluto152]

a LOT of pain management Drs. will not treat a patient unless the patient UAs/Drug tests on request. (well, the competent pain mgmt docs do routine and random drug testing of pain management patients).

So, while it may not be a state law? It is still a standard and necessary part of a treatment plan. You would have probably had to do the test if you wanted the narcs...

Not a pain med. Without going into unnecessary personal details, the prescribing Dr. is a psychiatrist. It's unfortunately not a time-limited diagnosis, so all the more frustrating when there's a presumption of abuse or even criminal activity. Random testing or one per year? I might buy that as reasonable. Every time I need to renew a script? Overboard and I'd argue not "standard and necessary". Certainly not a full tox screen, which vastly increased the costs I'm being billed for.

 

[Silverplum]

Not a pain med. Without going into unnecessary personal details, the prescribing Dr. is a psychiatrist. It's unfortunately not a time-limited diagnosis, so all the more frustrating when there's a presumption of abuse or even criminal activity. Random testing or one per year? I might buy that as reasonable. Every time I need to renew a script? Overboard and I'd argue not "standard and necessary". Certainly not a full tox screen, which vastly increased the costs I'm being billed for.

Patients are not the best arbiters of what is medically "standard and necessary."

And don't get testy with the FA volunteers: you're ascribing motives as you imagine them, not as they exist.

 

[Bluto152]

However, if the doctor is in network, he may have a contractual obligation to make sure his office sends your tests to the correct in network lab. So I repeat - when you called the doctor's office to complain that they sent your test to the wrong lab, what did they say?

The assistant that answered told me that I'm not obligated to pay the costs, that they have some agreement with the lab, but that the lab will still reach out for payment at the new year. Which sounds incredibly fishy to me.