CMS Office of Audit Services to begin review of Medicare Part B UDT Services

The Office of Inspector General (OIG) issued updates to its annual work plan in October 2019. This update included an announcement that the Office of Audit Services will begin a review of Medicare Part B urine drug testing (UDT) services. The report on this review is expected next year. Physicians use UDT to identify specific drugs in urine samples or to detect whether certain drugs are absent or present in the sample. The results of these tests impact treatment decisions. Additionally, nearly all, if not all, Medicare Administrative Contractors (MACs) have a Local Coverage Determination (LCD) which sets out the frequency and medical necessity requirements for coverage of UDT services.

Once the final report is issued, it is very likely that medical record reviews and audits will follow. Now is the time for laboratories and referring clinicians to conduct affirmative self-audit compliance review activities to ensure that all Medicare guidance related to UDT services is followed and accurately and thoroughly documented.    

For questions or assistance, contact the McDonald Hopkins Healthcare attorney listed below.