Baton Rouge Physician Laboratory Kickbacks: A Percentage of Urine-Testing Collections Returned to the Doctor

A physician who co-owned Louisiana Spine & Sports LLC, a Baton Rouge pain-management clinic, admitted in his guilty plea that he sent patients’ urine specimens to a drug-testing laboratory in return for a percentage of its reimbursements.

On November 20, 2018, he pleaded guilty to conspiring to pay and receive health care kickbacks. Medicare money paid for testing his patients’ specimens, then helped pay the doctor for sending them. The program and the taxpayers funding it were financing the referral reward.

Do Doctors Get Kickbacks for Ordering Tests?

Yes. In this case, the physician admitted agreeing to send his patients’ urine specimens to a laboratory for payments calculated as a percentage of what healthcare programs, including Medicare, paid the laboratory. The payment formula connected his compensation to the laboratory’s collections from the work he sent it.

The Office of Inspector General’s laboratory compliance guidance recognizes that laboratories depend on physicians to make medical-necessity decisions. It calls for requisition forms that preserve an independent decision about each test the laboratory will bill. In the Baton Rouge physician’s admitted arrangement, that ordering relationship also carried a payment back to the person supplying the specimens.

A specimen log shows where the work went. A reimbursement statement shows what the laboratory collected. The agreement tying a doctor’s compensation to those collections explains why the money returned to him. We examine those connections together when evaluating a laboratory referral arrangement.

Total Disbursements and Medicare Kickbacks

The Justice Department’s April 15, 2021 account of court documents in the criminal case reported approximately $1.58 million in laboratory disbursements to the physician. Within that total, approximately $336,000 represented kickback payments associated with testing specimens from Medicare beneficiaries.

Why Urine Testing Mattered to a Pain Clinic

Urine drug testing was already part of the clinical work of pain management. The 2014 Pain Physician review Ethical Perspectives on Urine Drug Screening for Pain Physicians describes its use in monitoring adherence to prescribed medication and detecting nonprescribed drug use.

The review also describes the financial pull of testing: large revenue streams may influence physicians to incorporate screening into their practices. Its clinical point is just as important. Results need context, and should not dictate patient management on their own. The work requires a physician’s judgment about the patient, not simply a specimen sent away and a result returned.

The physician’s guilty plea describes a financial interest attached to that clinical workflow: his choice of laboratory brought him a share of its reimbursements. The patient’s specimen was doing work for both the laboratory and the doctor who sent it.

This is why someone inside the clinic can see an important part of a laboratory fraud case. The laboratory holds the testing and billing side. The referring practice holds the patient relationship and the decisions that supplied the work. Understanding the arrangement means understanding both sides of that exchange.

Different Ways to Profit From the Same Specimen

In its September 12, 2018 criminal-case announcement, the Justice Department described an agreement to divide urine-toxicology profits equally between Accu Reference and pain-practice personnel.

The Baton Rouge physician’s agreement tied his payment to laboratory reimbursements.

What a Laboratory Insider Can Explain

Someone who understands both the specimen flow and the compensation arrangement can connect decisions that otherwise appear in separate files. In the Baton Rouge case, the doctor’s own admissions connected the patient specimens, laboratory reimbursements and payments back to him. Those are the relationships our whistleblower experts examine with someone who has seen a similar arrangement at work.

A clinic employee may understand how the laboratory was chosen and how referrals moved through the practice. Someone in laboratory billing or finance may understand the collections used to calculate a distribution. Someone involved in negotiating compensation may know what the parties agreed the payment would buy. Our whistleblower experts show you how what you know fits the testing, the claims and the money.

The referral payment can also matter to the government’s claim for repayment. In its oncology and reference-laboratory settlement announcement, the Justice Department explains that claims submitted in violation of the Anti-Kickback Statute may create liability under the False Claims Act. The connection is between buying the referral and billing the government for the resulting work. Our experts assess that connection with you and laboratory fraud whistleblower counsel.

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Know Why the Specimens Went There

If you know how a laboratory’s collections became payments to a referring doctor, speak to one of our whistleblower experts about how those payments came back to the doctor. We build the case around the decisions and payments you can explain, bring in laboratory fraud whistleblower lawyers who understand referral compensation, and stay beside you through the case.