A new study from the CaliforniaWorkers' Compensation Institute (CWCI) found drug tests havebeen added to more Workers' Compensation pain management programsin published treatment guidelines throughout the state ofCalifornia. The increased use of opioids over the past decade andgrowing concerns about the long-term reprecussions have influencedthis increase, says CWCI.

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In the report, titled "The Utilization and Cost of Drug Testingin the California Workers' Compensation System," CWCI analyzed adatabase of 2.8 million clinical lab service records for urine drugtests (UDTs) performed on California injured workers between 2002and 2014, for which claims administrators paid $108 million.According to Stacy Jones, CWCI senior research associate, UDTs as apercentage of all California WC lab services increased nearlysix-fold over the last eight years — from 10.2% in 2007 to 59.1% in 2014. As aresult, UDT payments went up from 23% to 77% of WC lab paymentsover the same period.

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(Click the chart on the right for full size.)

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According to CWCI, these increases reflect a growing number ofinjured employees who were tested, as well as an increase in theaverage number of drug testing dates, tests performed on thosedates and the duration of testing within the life of the claim.

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The amount paid for drug tests in California WC are based onMedicare billing rules. These rules were revised in 2010 and 2011,after Medicare determined there were questionable billing practicesfor drug tests taking place.

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The CWCI study found that after those changes were made, the mixof tests used on injured workers changed. Drug screens, which areused to identify the presence or absence of a drug, accounted for asmaller share of UDTs. Meanwhile quantitative tests, which areused to measure the amount of a drug sample, increased sharply.CWCI notes quantitative tests are not subject to the tighterMedicare billing rules, perhaps explaining the increase.

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(Click the chart on the left for full size.)

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The study also notes that from 2007 to 2014, the percentage ofUDT payments to the top 10 providers or labs fell from about 80% to46%.

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(Click the chart on the right for full size.)

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At the same time, CWCI notes the number of providers who werepaid for testing injured workers climbed from 428 in 2008 to 876 in2014. Much of that growth is attributed to a migration towardsphysician in-office testing.

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For more information and to read the whole report, "TheUtilization and Cost of Drug Testing in the California Workers'Compensation System" from CWCI, download it HERE.

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