This is called a qualitative test - or more colloquially, a screen. Samples are first run through a screening analyzer, a device that can detect more than a dozen drugs, such as cocaine and marijuana. “Monday is the busiest day,” she said, “because that’s when all the weekend samples arrive.” Anywhere from 25 to 200 specimens a day arrived at A New Start’s lab, according to Theresa Lee, former chief scientist for the company. Baker’s samples were sent to the 46,000-square-foot Alexandria Innovation Center, where the labs for both A New Start and Seamless were based. Baker, like countless other patients, provided samples to both his sober home and his treatment facility.Īll of Mr. Because Seamless had its own urine testing lab, Mr. Baker lived at a nearby sober home called Seamless, with about 15 other drug users. At 6 feet 2 inches and just 140 pounds, he had been bullied in high school, according to his mother, and found community with a crowd that was into drugs.Ī New Start is an outpatient program, which means that it offers therapy but not housing. Baker entered A New Start six years after he had become a heroin addict in his hometown, Forkston Township, Pa. “A lot of the people who start these treatment centers are reformed abusers, and it’s as though they turn from one craving to another - from drugs to money.” A Markup of 2,000 Percent “Some of these places have cleared $400,000 a month in profit,” said Brian Crowley, the chief executive of Integra Enterprizes, which consults with clinics that want to open labs. They tend to be the loudest critics of those on the other side of this battle - the clinic owners who realized that their clients’ urine is a path to riches. On one side are the clinic owners who have never cashed in on urinalysis and are aghast at the cascade of money now pouring into the pockets of their competitors. The windfall has roiled the rehab industry, which is in the midst of a kind of civil war. In recent months, insurers have started to ratchet down reimbursement rates for urine tests, but profit margins remain enticingly high. “15 samples per day could yield $800,000 in profit!” read one email sent last year by Mercedes Medical, a supply company in Sarasota, Fla. The clinics that have yet to jump into the lab business are now inundated with breathless pitches from companies that specialize in helping to set up complete, ready-to-run labs for clients. Thousands of small, clinic-owned labs have quietly sprouted nationwide, ramping up the competition for independent labs that once dominated the industry. Three days later, his body was discovered in the parking lot near a friend’s apartment. When managers at his sober home found the steroids in his possession, he was evicted. Baker, a weight lifter, was actually taking: steroids. The tests, though, did not search for the one drug Mr. Baker’s urine, for instance, was tested for amphetamines, antidepressants, antipsychotics, barbiturates, benzodiazepines (a class of sedatives), and the list goes on. Rehab centers and labs say extensive testing is necessary because clients are getting high with rare designer drugs and exotic combinations of over-the-counter medications. “It didn’t seem possible.” ‘From Drugs to Money’ “We were shocked,” said Lizz DeWolfe, Mr. They cataloged dozens of urinalysis tests both from Living Tree and from the sober home where he lived, which ran its own urinalysis lab. A few months after he started treatment there, in early 2015, two bills arrived at his father’s home. One of A New Start’s clients was a 23-year-old named John Baker. One lab, Living Tree Laboratories, which shares ownership with A New Start, a clinic in West Palm Beach, Fla., is suing UnitedHealthcare for $12 million. Some clinic-owned labs have returned fire, too, with lawsuits claiming that they are owed millions for urinalysis tests that insurers refused to cover. Baker’s mother, Lizz DeWolfe, visiting her son’s grave.
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