Patients in active treatment for substance use disorder may also be treated for a variety of medical conditions. Medicare Part B covers these patients’ drug testing services when reasonable and necessary. For 2019, Medicare paid $180 million for such services provided to 274,000 beneficiaries with substance use disorders nationwide. Although the 2019 Medicare fee-for-service improper payment rate was 7.3 percent, the improper payment rate was 58.9 percent for the drug test with the highest Medicare fee schedule amount. We conducted this audit to evaluate how the Centers for Medicare & Medicaid Services (CMS) and its Medicare contractors addressed the risk for improper payments for drug testing services. Our objective was to assess the Medicare contractors’ program safeguards for ensuring that Medicare claims for drug testing services for beneficiaries with substance use disorders comply with Medicare requirements.Our audit covered Medicare Part B claims for drug testing services provided in 2019 for beneficiaries with substance use disorders. We interviewed CMS officials and reviewed requirements for drug testing services in all seven Medicare contractors’ Local Coverage Determinations (LCDs). We also interviewed staff from seven selected laboratories and analyzed claims data to determine the potential impact of weaknesses we identified.
| Report Date | Agency Reviewed / Investigated | Report Title | Type | Location | |
|---|---|---|---|---|---|
| Department of Health & Human Services | Opportunities Exist for CMS and Its Medicare Contractors To Strengthen Program Safeguards To Prevent and Detect Improper Payments for Drug Testing Services | Audit | Agency-Wide | View Report | |
| Department of Homeland Security | Semiannual Report to The Congress October 1, 2020 - March 31, 2021 | Semiannual Report | Agency-Wide | View Report | |
| U.S. Agency for International Development | Examination of Costs Claimed by The Kaizen Company for Fiscal Year Ended December 31, 2017 | Other |
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View Report | |
| Environmental Protection Agency | EPA's National Vehicle and Fuel Emissions Laboratory Has Taken Steps to Mitigate Impact of Coronavirus Pandemic on Mobile Source Emission Compliance | Audit | Agency-Wide | View Report | |
| Internal Revenue Service | Criminal Restitution Assessment Procedures Need Improvement | Audit | Agency-Wide | View Report | |
| Board of Governors of the Federal Reserve System | The Board's Payroll Controls Are Generally Effective | Audit | Agency-Wide | View Report | |
| Department of Agriculture | USDA’s Fiscal Year 2020 Compliance with Improper Payment Requirements | Audit | Agency-Wide | View Report | |
| Department of Justice | Management Advisory Memorandum: Notification of Security Concerns at the Federal Bureau of Prisons Camp Locations | Other | Agency-Wide | View Report | |
| Environmental Protection Agency | Informe: La EPA debe realizar nuevas revisiones de tecnología y del riesgo residual de las categorías de fuentes que emiten cloropreno y óxido de etileno para proteger la salud humana | Audit | Agency-Wide | View Report | |
| Department of Justice | Management Advisory Memorandum: Notification of Security Concerns at the Federal Bureau of Prisons Camp Locations | Other | Agency-Wide | View Report | |