Logan Laboratories and Tampa Pain Relief: Every Patient, Every Visit

In the Logan Laboratories Tampa Pain Relief settlement, the laboratory, pain clinic and two former executives agreed to pay $41 million to resolve allegations of medically unnecessary urine drug testing. The government alleged that they automatically ordered both screening and definitive tests for every patient at every visit, without a physician deciding whether either test was needed. For someone who worked with the orders, the panels or the bills, the question is familiar: who actually chose what to test?

The Department of Justice announced the civil False Claims Act settlement on April 15, 2020. The alleged false claims ran from January 1, 2010 through December 31, 2017. Whistleblowers filed two qui tam cases in Pennsylvania and Florida, and the government joined both. The complaints describe how an ordinary pain-management visit could become a recurring source of laboratory business before the physician made a decision about testing.

The Clinic Screened, the Laboratory Confirmed

Tampa Pain Relief Centers was a pain clinic based in Tampa, Florida. Logan Laboratories was a reference laboratory in the same city. Both were subsidiaries of Surgery Partners. Their roles in the alleged testing practice were different: Tampa Pain performed the presumptive tests, Logan performed the definitive tests, and each submitted the resulting claims to federal healthcare programs.

Presumptive urine drug testing screens for the presence of drugs. Definitive testing identifies particular drugs and their concentrations. A clinician can use urine testing to check for illicit substances and whether a patient is taking prescribed medication. The 2014 Pain Physician paper Ethical Perspectives on Urine Drug Screening for Pain Physicians describes those uses and how quantitative results can inform questions about drug interactions and metabolism.

Medicare, Medicaid, TRICARE and other federal health care programs, including federal workers’ compensation, received the bills. According to the Justice Department, neither test had an individualized physician determination of medical necessity under the alleged policy. A patient visit supplied business to both sides of the clinic-laboratory relationship. Under the alleged policy, taxpayers paid for tests ordered without regard to what the patient needed.

The two former executives who settled had responsibilities across that relationship. One had been chief executive of Surgery Partners and Logan. The other had overseen Logan as Surgery Partners’ group president for ancillary services and had been a vice president at Tampa Pain.

How the Order Was Made Automatic

The Pennsylvania whistleblowers alleged that the electronic ordering system selected a broad confirmation panel and restricted the physician’s choice of laboratory. Their complaint described the use of NextGen in Surgery Partners practices to couple a drug screen with confirmation testing for all patients, without customization options.

The laboratory also allegedly obtained an authorization that lasted well beyond the visit when it was signed:

Calling a panel customized does little for the patient if the choice was made for a year of specimens. The alleged authorization supplied a physician’s signature while taking the decision about a smaller panel out of the next encounter.

The Florida amended complaint described the process even earlier, at check-in. A physician alleged that staff collected specimens before he saw the patient or ordered a test. Names of patients whose insurance would cover Logan testing, including government program beneficiaries, were allegedly highlighted in yellow for referral.

Laboratory choice was another point of control. The Florida complaint alleged that when a physician at a Surgery Partners practice in Colorado referred patients to other laboratories, staff overrode the orders and redirected the specimens to Logan.

The Pennsylvania complaint also alleged pressure on the sales team to promote an even larger panel despite complaints about excessive testing. Taken together, these allegations describe decisions made in software, standing authorizations and management instructions. The person signing a requisition could be the last participant in a choice already made elsewhere.

When Are Toxicology Tests Unnecessary?

Toxicology tests are unnecessary when they do not serve the particular patient’s medical needs. In the Logan and Tampa Pain case, the government alleged that the testing policy replaced that patient-specific decision with an automatic order for both types of test at every visit.

The clinical literature explains why frequency matters. The Journal of Family Practice’s 2021 review, Urine Drug Screening: A Guide to Monitoring Tx With Controlled Substances, describes testing frequency based on risk and ongoing assessment, including patient history, prior results and behavior. In its discussion of addiction treatment, it also describes routine testing at every visit as often unnecessary for stable patients.

The same review describes the tradeoff between the testing methods. Immunoassay screening gives rapid, comparatively inexpensive results. Liquid chromatography with mass spectrometry provides more specific confirmation, at greater cost and with a longer wait for results. The clinical question helps determine which method is useful. Automatically ordering both removes that choice from the individual visit.

The Florida complaint alleged that a revised policy required confirmation testing for every new patient and every medication change, including a dose adjustment. It described the instruction to the pain specialists this way:

The test order thus sat between the patient and the prescription.

The same whistleblowers also alleged that Surgery Partners manipulated the electronic risk-classification tool to put more patients into the high-risk group and justify more frequent testing. If the software moves patients into a higher-risk category to justify testing, the risk label becomes part of the sales process.

Can a Toxicology Report Be Wrong?

Yes. The Journal of Family Practice review explains that interference can produce false-positive and false-negative immunoassay results. The review puts it plainly:

The Pennsylvania complaint alleged a separate problem with Logan’s reports: drug ranges that did not fit the patients’ condition. One physician reported results so far out of range that they suggested hospitalization or coma. The complaint also alleged that another physician mistakenly discharged two patients because of a Logan reporting error.

An insider may see the repeated orders, the physician’s questions about the results, or the response inside the laboratory. In this complaint, concerns about unnecessary testing sat alongside concerns about what the resulting reports told physicians.

Two Integrity Agreements and a Shared Settlement

Logan entered an Integrity Agreement with the Department of Health and Human Services’ Office of Inspector General, while Tampa Pain entered a Corporate Integrity Agreement.

The OIG entry for Tampa Pain describes a five-year agreement. Florida Medicaid also shared in the settlement.

The Justice Department announced that the whistleblowers in the two cases would collectively receive approximately $7.79 million of the settlement. The Pennsylvania complaint came from employees whose roles included laboratory account management and marketing. They could describe how the testing business reached physicians, as well as what the laboratory sold.

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

What a Laboratory Insider Would Recognize

The central connection is between the testing decision and the claim it produces. In the industry, the treating practitioner orders the test and holds the clinical documentation, while the laboratory performs the service and submits the claim. In this case, the government alleged that both the clinic’s screening claim and the laboratory’s definitive-testing claim grew out of an automatic ordering policy.

The complaint’s yearlong authorization shows why a signature alone can leave that decision unexplained. The Florida complaint added another document: preprinted medical-necessity attestations for Logan, which a physician eventually refused to sign. The question behind those forms is who decided that this patient needed these tests at this visit.

The money also followed the breadth of testing. Medicare’s definitive-testing payment categories group drug classes into tiers, with higher rates for broader testing. The Florida complaint alleged that physician incentive compensation depended in part on profits from Surgery Partners’ ancillary services, including Logan. That makes the panel configuration and the compensation arrangement relevant to understanding the alleged push for volume.

The recurring panel also appeared in another laboratory’s civil settlement. In 2023, Genotox Laboratories admitted offering custom profiles that let providers preselect tests for all or nearly all their patients, which Genotox then performed and billed, generally in the highest reimbursement categories. The parallel is the form that makes one selection repeat across patients.

For the Logan and Tampa Pain allegations, we connect the electronic order, the authorization, the referral destination, the report and the submitted claim. A clinic employee may know which choices were available on screen. Laboratory staff may know what panel actually ran. Billing or compliance staff may know how the physician’s authorization was used to support payment. Each view helps explain how the visit became a bill.

You Saw How the Tests Were Chosen

If your clinic or laboratory turned a patient visit into an automatic testing order, speak to one of our whistleblower experts about how those tests were ordered. We build your strongest laboratory fraud whistleblower case around the decisions behind the claims. We bring in laboratory fraud whistleblower lawyers who understand toxicology billing and stand beside you through the case.