Seattle Pain Center: A Full Panel at Nearly Every Visit

In the Seattle Pain Center laboratory settlement, the clinic owner agreed to pay $2.85 million to resolve allegations that his businesses billed government programs for medically unnecessary urine drug tests. The alleged driver was a rule inside the practice: a full panel at nearly every visit, sent to a laboratory the same owner controlled. For clinic and laboratory staff, that puts the case in the daily workflow, where the order, specimen and bill meet.

The Department of Justice and Washington Attorney General announced the civil resolution on May 7, 2020. Their accounts describe how a pain-management visit became a recurring source of laboratory work, with government health care programs billed for tests that the agencies said patients did not need.

How the Clinics Fed the Laboratory

Seattle Pain Center’s owner also owned drug-testing laboratories in Seattle and Everett. Northwest Analytics performed urine drug testing for the clinics. According to the Justice Department’s account of the settlement agreement, the owner introduced the full-panel policy in July 2013: in nearly every instance, a patient had to receive a full urine drug test panel each time a provider saw them.

The Washington Attorney General’s account describes routine and excessive orders from July 2013 to February 2015, with specimens sent to Northwest Analytics, which the clinic owner owned exclusively. The state alleged that providers ordered tests for drugs they already knew patients were or were not taking, including prescribed drugs. It said Seattle Pain Center billed Medicaid for urine tests on most patients, even when the tests were unnecessary.

That is a consequential place to put a default. The patient comes back for care, and the laboratory gets another full panel. In the government’s account, the policy produced thousands of medically unnecessary tests.

Here, the alleged blanket policy came from the person who owned both the clinics generating the orders and the laboratory receiving them.

An employee who knows how the panel was selected may therefore know something the claim alone cannot show: whether the order reflected the patient in front of the provider or a policy already set for the practice.

When Are Toxicology Tests Unnecessary?

Toxicology tests can be unnecessary when the frequency or breadth of testing runs ahead of the patient’s clinical need. In the Seattle Pain Center case, the state alleged that an every-visit policy displaced the individual assessment and documentation Medicaid required for each patient’s tests.

A 2021 clinical review in The Journal of Family Practice, Urine Drug Screening: A Guide to Monitoring Tx With Controlled Substances, describes the same concern from the treatment side. It identifies large, expensive panels, excessive frequency and unnecessary confirmation of positive screens as practices associated with insurance fraud where testing businesses have a financial interest.

In its discussion of addiction treatment, the review makes a pointed observation about testing tied to appointments:

A standing instruction can put the same answer on every order before the provider considers what that patient needs.

In its 2020 announcement, the Justice Department said the clinic’s protocol departed from state standards recommending random testing up to four times per year.

What the Civil Settlement Covered

The settlement addressed government billing for medically unnecessary urine drug tests. The Justice Department said the amounts were based in part on the owner’s ability to pay.

The announcement allocated $1,590,265 to Medicare and $1,134,151 to Medicaid. It also allocated $123,000 to TRICARE and $2,672 to the Railroad Retirement Board. The Medicaid allocation included both federal and state funds.

The same announcement reported that the Department of Health and Human Services’ inspector general had excluded the owner from Medicare and Medicaid.

The Laboratory’s Licensing Gap and the Clinics’ Closure

Northwest Analytics lacked the license or accreditation to perform urine drug tests from 2013 to 2014, according to the Washington Attorney General. The owner’s clinics were sending specimens to a laboratory the state said was not licensed to test them.

The state also reported that the Washington State Health Care Authority suspended Medicaid payments to Seattle Pain Center in 2015 after the testing investigation began.

The Justice Department reported that the clinics closed in July 2016 when the regulator suspended the owner’s medical license for improperly monitoring opioid prescriptions.

A Signature Can Set Testing in Motion for a Year

The Logan Laboratories complaint alleged yearlong panel authorizations that bypassed individual testing decisions, while Genotox Laboratories admitted in its 2023 civil settlement that custom profiles preselected tests for all or nearly all of a provider’s patients.

What the Policy Leaves in the Records

In this case, the agencies described a nearly universal panel instruction from the owner, specimens sent to his own laboratory and bills for tests patients allegedly did not need.

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

You Saw How the Panel Was Chosen

If you saw a clinic turn nearly every visit into a full-panel order, speak to one of our Whistleblower Experts about the instructions behind those tests. We build the case with you and bring in laboratory fraud whistleblower lawyers who understand how clinic orders become government claims. We stay beside you as your knowledge of the practice becomes the foundation for pursuing a recovery.