Coastal Spine and Pain will pay $7.4M to settle billing fraud allegations

Jacksonville, Fla.-based Coastal Spine and Pain has agreed to pay the federal government $7.4 million to resolve allegations Coastal violated the False Claims Act by billing government payers for medically unnecessary drug screenings, according to the Department of Justice.

The allegations against Coastal center on its use of quantitative drug tests. According to the DOJ, it's appropriate to use quantitative drug tests to identify and count particles of illicit drugs in a patient's urine only if there is reason to doubt the more general and cheaper qualitative drug test results. The government alleges Coastal performed and billed for quantitative drug tests for all patients, regardless of the results of the qualitative test. 

A review of claims data prompted the DOJ's investigation. Each time Coastal billed for a qualitative screen it also bill for a quantitative screen, making it a statistical outlier. 

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