Aspirar Medical Lab: A Payment for Each Referred Test

In the Aspirar Medical Lab settlement, the laboratory and its owner agreed to pay $1,951,090 to resolve allegations of urine drug testing kickbacks and medically unnecessary North Carolina Medicaid claims. The government alleged that Aspirar paid for each referred test while the orders failed to reflect a qualified medical provider’s decision that the patient needed it. The alleged arrangement rewarded referrals while billing a taxpayer-funded healthcare program for tests patients did not need.

Aspirar operated in Cary, North Carolina. The Justice Department announced the civil settlement on August 4, 2023. The allegations covered claims submitted from March 25, 2016, through September 19, 2017.

How BPolloni and D4H Supplied the Referrals

The government alleged that Aspirar paid BPolloni Consulting for each urine drug test referred by BPolloni or Do It 4 the Hood Corporation, called D4H in the announcement.

That payment formula gave the referral business a financial interest in each additional test. The clinical question sat elsewhere in the transaction: what had a qualified medical provider decided this particular patient needed?

In the same announcement, the Justice Department separately reported earlier guilty pleas by BPolloni’s chief executive and people who operated D4H. Those pleas concerned conspiracy to commit health care fraud and Anti-Kickback Statute violations arising from D4H’s illegal kickback arrangements with urine drug testing laboratories.

When Are Toxicology Tests Unnecessary?

In Aspirar’s case, the United States alleged that the urine drug tests were medically unnecessary because the orders were not patient-specific and did not reflect a qualified medical provider’s determination of the patient’s need.

The referral identifies where the business came from. The order and medical record explain why the patient should receive the test. Someone working with the referral account may know exactly how the specimen reached the laboratory while knowing little about the clinical decision behind it.

The industry’s division of work helps explain why those records matter. The lab’s billing staff and the treating provider can therefore see different parts of the same transaction.

For Medicare laboratory services, the Centers for Medicare & Medicaid Services’ May 2026 documentation guidance connects those parts. The treating provider orders the tests and documents medical necessity. The entity submitting the claim keeps the order, the medical information it received and documentation of accurate processing and billing.

The Patient Changes the Testing Decision

Urine drug testing has a clinical purpose that depends on the patient and the treatment setting. The 2021 Journal of Family Practice review Urine Drug Screening: A Guide to Monitoring Tx With Controlled Substances describes testing used to evaluate and treat substance use disorders and to monitor patients receiving controlled substances.

For patients receiving prescribed controlled substances, the review recommends a testing frequency informed by ongoing assessment, including the patient’s account, earlier toxicology results and prescription monitoring. It separately describes addiction-treatment settings, where testing can become less frequent as the patient’s condition improves.

The review gives a concrete example of how specimen collection and laboratory testing can be separate decisions:

The specimen can already be in hand while the decision to send it for testing remains separate. A lab insider can recognize the difference between a collection routine and a clinical decision that produces a bill. Aspirar’s alleged per-test payment rewarded the referral business for the testing volume it supplied.

The Same Question in Genotox’s Order Forms

Genotox Laboratories admitted in its civil settlement that it offered custom profiles through which a provider preselected tests for all or nearly all of the provider’s patients. Genotox then performed and billed those tests, generally in the highest reimbursement categories. The form made a broad testing decision repeat across the practice.

The whistleblower’s complaint made a separate allegation about how the company named its standing orders:

The Genotox admission shows how a selection made for a practice can determine testing across many patients. An insider who understands how the form works can explain whose decision it represents.

What a Laboratory Insider Can Connect

A person who knows the referral arrangement can connect the payment formula to the tests the laboratory billed. Someone who handled orders may know how the requested testing was selected and what patient-specific information accompanied it.

For a case involving this pattern, our work with an insider connects the referring business, the order, the clinical support, the test performed, the payer billed and the payment returned to the referral source. A billing employee may see the claim without seeing the referral contract. A marketer may know the compensation formula without seeing the medical record. We build the account around what you know and how the pieces fit together.

The substance lies in what the referral payment bought and whose decision selected the tests. Understanding that connection is where your knowledge of the laboratory’s business becomes the foundation of a whistleblower case.

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

You Know How the Tests Reached the Lab

If you saw referral fees driving urine drug testing without patient-specific orders, speak to one of our Whistleblower Experts about the referral payments. We work with you to build your strongest laboratory fraud whistleblower case and bring in laboratory fraud whistleblower lawyers who understand toxicology billing and referral payments. You gain a partner who stays beside you through the case, from the first account of the arrangement to the pursuit of a recovery.