Drug testing w/o consent

[allical1284]

I wasn't sure if I should post this here or in Birth Professionals; mods please feel free to move.
I have been seeing a hospital-based CNM group for back-up care during this pregnancy. Basically because it gives me a place to get free (i.e. insurance covered) u/s if needed and I won't have to deal with strangers if we have to transfer during our HB. They are unaware of our intentions to birth at home w/ a different MW.
When I went in for my first appt. (not really my 1st appt. with them seeing as I had my DD w/ this practice 17 months ago), they did the standard 'give us a cup of your urine' routine. The nurse requested a clean catch so they could check for a UTI (which I was fine with. I had a symptomless UTI early in my last pregnancy).
The other day I got a bill in the mail from Quest Diagnostics for $144.62. Our new insurance has a deductible on some diagnostics. Here is a breakdown of the bill:
Test Desc. Charge
CULT, PRES ID EA ISOL URI $25.50
CULT, BACTERIAL (UR) $49.00
AMPHETAMINES (1000 N) $553.00
UA, COMPLETE AUTOMATED $37.00
AEROBIC DEF ID $25.50
ANTIBIOTIC SENS, MIC $55.00

TOTAL: $745.00 Insurance covered: $600.38 I owe: $144.62

Am I reading this right? Did they test me for amphetamines?!?! I am ticked for multiple reasons! 1) I wasn't informed of the test beforehand 2) They have NO reason to suspect that I needed to be drug tested and 3) I am now responsible for paying for this!

Any suggestions? I plan to ask my HB MW about this when I see her this weekend.

[finnegansmom]

I would call the insurance pronto. Not to give the benefit of the doubt but it could have been coded incorrectly.

I have received bills that were incorrect before...

But otherwise, I have never heard of drug testing during pregnancy. So weird...is that normal? I had a CBC but I saw my results and it was things like iron levels, etc. I don't even know what an amphetamine is. LOL.

[nia82]

I'd call. It is not out of the ordinary though. At Kaiser in CA they made me sign a thing that allowed them to test me for all drugs, I was told it is state mandated. Little did I know back then, it's not true. But I didn't care as I had Kaiser HMO and didn't have to pay anything out of pocket (my employer paid the full premium as benefit).

[GolfAddict]

I believe I was tested for drugs as well. I think if you rejected it then they would probably say they can not treat you. That may not a big deal for you since you weren't really planning on using them anyway.

And I'm sure in all of those documents you signed during your first appt, there was probably one that said something to the effect "I will allow them to treat me including whatever tests they feel like running at whatever cost".

[IdentityCrisisMama]

$500 to test for amphetamines w/o your consent? I'm hearing all kinds of crazy stories on MDC today.

[purplepaisleymama]

The CNM/OB practice that I used for backup this pregnancy has a line in their welcome to the practice paper that references your consent to being tested randomly for drugs.....I am not sure which types of drugs but I would guess it would include amphetamines.

I was not happy with this so I made sure not to pee in a cup for the appts that I went to...... they only seemed to use a test strip for the one time I did...my first appointment.This practice is in a smallish town and I have private insurance. I know that they serve a large number of state insured patients. I know that when I was in the hospital at 28 weeks for possible pre-term labor they did a clean catch to test for uti and I am pretty sure that they tested for drugs. This hospital is the largest one in the area and they serve many state and non-insured patients. I think that it may be common for women to be using and seek care at this hospital ( if when our son was in the NICU and there were many babies there for addiction and withdrawal, usually with parental rights terminated is any indicator)

[allical1284]

Thanks for the replies! As for signing any consent form, I haven't signed ANY paperwork for them since the very beginning of my last pregnancy (July 2008). So it has been over 2 years since they have gotten any signatures from me. Even then, I don't recall signing anything that said 'we have the right to test for for anything, blah, blah...' Although, I have to admit I didn't get the microscope out when reading through everything
I'm willing to bet that they did the same test when I was pregnant with DD, but because our insurance at the time covered it all, I never got a bill and never even found out about it. I am soooo over the entire conventional medical establishment, but that is another topic I'm now remembering why we avoid it at all costs.
I called the MW's billing dept. and they told me to fax in a copy of my invoice and they would check all the billing codes, but she didn't seem surprised when I told her about the test. I guess they got what they wanted though...my insurance company reimbursed them over $600 for a few simple urine tests.
I am not going to let this go without a major fight!!

[babyjelly]

I'd be pretty upset, if I were you, but the PP is probably correct that somewhere in your initial forms, there was something which they interpret as your giving consent to being drug tested.
However, I would make an issue of the two seperate tests. They did a urinalasis, which screens for a number of drugs-including amphetamines. The second amphetamines test should only have been run in the event that something showed up in the UA-it is used to distinguish between something like an OTC cold medicine and crystal meth.
ETA: I just saw that you haven't signed anything this pregnancy, so the part about consen doesn't stand. the rest does, though. The extra test is ridiculous.
Posted via Mobile Device

[allical1284]

Originally Posted by babyjelly

However, I would make an issue of the two seperate tests. They did a urinalasis, which screens for a number of drugs-including amphetamines. The second amphetamines test should only have been run in the event that something showed up in the UA-it is used to distinguish between something like an OTC cold medicine and crystal meth.
Posted via Mobile Device

Interesting! I wasn't aware that the standard UA tested for some drugs as well! Thanks for sharing. Yeah, there is absolutely NO way that anything would have shown up in the UA which would have warranted the additional amphetamines test. Arggg....

[Kellyh_01]

I work in a hospital and every patient that comes in to maternity is tested. What makes it legal is that EVERYONE is tested - we don't "profile" or try to guess who looks like they might use drugs. It's every single woman, regardless of name, insurance, income, doctor, anything. Also, any pregnant woman who comes to the ER for treatment of any kind is tested as well. It is very common.

[IdentityCrisisMama]

I had no idea that was even legal, Kellyh_01. Is she then expected to pay for it? That is a serious question.

[Theoretica]

Originally Posted by Kellyh_01

I work in a hospital and every patient that comes in to maternity is tested. What makes it legal is that EVERYONE is tested - we don't "profile" or try to guess who looks like they might use drugs. It's every single woman, regardless of name, insurance, income, doctor, anything. Also, any pregnant woman who comes to the ER for treatment of any kind is tested as well. It is very common.

Tested for WHAT exactly???

[onlyboys]

Typical urinalyses do not test for drugs, at least here in FL. There might be a separate code for that, but it's not included in the standard U/A. In the practice I was in, we did (on occasion) test for drugs, but it was done after informed consent.

Call your insurance company and speak to your MW practice immediately. Hope it all resolves.

[reticentwife&mama]

Originally Posted by Kellyh_01

I work in a hospital and every patient that comes in to maternity is tested. What makes it legal is that EVERYONE is tested - we don't "profile" or try to guess who looks like they might use drugs. It's every single woman, regardless of name, insurance, income, doctor, anything. Also, any pregnant woman who comes to the ER for treatment of any kind is tested as well. It is very common.

I'm surprised more people aren't aware of this. When my sister was a teenager, running with a not-so-great crowd, all the girls knew not to give birth in the next county over if you couldn't test clean b/c the hospitals there tested for drugs, while the hospitals in our county didn't. I don't know if all our local hospitals do now or not, but I always thought it was interesting that the ones the hospital was trying to "catch" already knew about the testing and so many innocent people had no clue.

[javilu]

I'm in CA and my routine urine test did NOT include a drug test.

[Kellyh_01]

Originally Posted by Theoretica

Tested for WHAT exactly???

A toxicology screen - a urine drug test. It tests for alcohol, amphetamines, cocaine, barbituates, narcotics, etc. It is separate from a urinalysis.

Testing obviously varies by location. Our hospital happens to have the policy that it is done. One of the OBs also tests all of their patients at the first prenatal visit. Not all doctor's offices or hospitals do. If a patients tests positive then a referral is offered to the pt. for counseling if they desire it, or CPS can be notified if necessary. I have no idea about the cost or billing if you're a private pay patient. I know personally that my insurance paid it, and that medi-cal covers it.

[Drummer's Wife]

It seems odd to me that they'd only test for amphetamines. If they wanted a decent UA done, that still leaves a lot of drugs, yk?

I recall a blurb in my initial paperwork with the midwives that drug testing may be done at some point (it wasn't standard, but at their discretion). I don't believe a UA was done when I had four c-sections -- But I know it depends on the hospital and whether baby is premature/sick. Speaking of, I know for sure I was tested for drugs when I got sick and showed up in the ER a couple years ago (and ended up admitted to the hospital for 3 weeks). I didn't consent to anything, but they talked about it when I was wheeled into surgery -- at that point, what was important was if drugs in my system could interact with anesthesia. So, obviously it's not illegal or uncommon to have it done w/o the patients knowledge.

[angelpie545]

As invasive as it seems, I completely understand why hospitals test for certain drugs during labor. Withdrawal can be deadly for infants for it's important to know as much beforehand as possible, plus drug addicted patients are often less than forthcoming. With that said, I think it's ridiculous to throw a fit if the mother tests positive for something like THC (pot). It's not physically addictive (though psychologically it certainly can be) and not known to have adverse effects on the newborn. It also is not a predictor of child abuse, whereas use of cocaine, meth, heroin, ext, usually are (and that's not counting the damage done inutero).

[allical1284]

Originally Posted by angelpie545

As invasive as it seems, I completely understand why hospitals test for certain drugs during labor. Withdrawal can be deadly for infants for it's important to know as much beforehand as possible, plus drug addicted patients are often less than forthcoming. With that said, I think it's ridiculous to throw a fit if the mother tests positive for something like THC (pot). It's not physically addictive (though psychologically it certainly can be) and not known to have adverse effects on the newborn. It also is not a predictor of child abuse, whereas use of cocaine, meth, heroin, ext, usually are (and that's not counting the damage done inutero).

It isn't the drug test itself that bugs me, it is the fact that my MW's did not inform me of the test beforehand. I would have been equally as pissed if it had been a totally different (yet equally unnecessary) $500 test. I am very protective of my blood; I don't readily give up my blood for testing unless I know exactly every test that they are planning to run; however, it never occurred to me that I should treat my urine the same. To me it isn't about drugs, it is about not allowing healthcare providers to have full reign over my rights as a patient.

[misskira]

Originally Posted by allical1284

It isn't the drug test itself that bugs me, it is the fact that my MW's did not inform me of the test beforehand. I would have been equally as pissed if it had been a totally different (yet equally unnecessary) $500 test. I am very protective of my blood; I don't readily give up my blood for testing unless I know exactly every test that they are planning to run; however, it never occurred to me that I should treat my urine the same. To me it isn't about drugs, it is about not allowing healthcare providers to have full reign over my rights as a patient.

That's very reasonable. I totally get where you're coming from.