Blue Cross/Blue Shield of Alabama proposes to significantly limit urine drug toxicology testing reimbursement

BCBS Alabama has released a draft policy entitled “Urine Drug Testing in Pain Management” that seeks to place significant reimbursement restrictions on urine drug toxicology testing.  This is an important development, as BC/BS controls approximately 90% of the Alabama market. BC/BS provides a short summary that explains its rationale for issuing this draft policy.”There is limited published evidence on the diagnostic accuracy and clinical utility of urine drug testing in the pain management and substance abuse treatment settings. There are no randomized controlled trials (RCTs) that isolate the potential effect of urine drug testing on patient management/health outcomes in the pain management setting. Based on the available evidence and clinical input, urine drug testing may be considered medically necessary under specific conditions listed in the policy statements.” As noted above, this is just a draft policy at this point, and providers who participate in Alabama BC/BS can provide feedback.