Since 1995, Reliable Business Intelligence for Clinical Laboratories, Pathology Groups and Laboratory Diagnostics

June 2013

Why a Divided Lab Industry May Soon Fall

OVER THE PAST TWO DECADES, it has often been remarked on these pages and by many others that the divided nature of the laboratory medicine profession will prove to be its ultimate Achilles heel. These divisions center around different scientific disciplines within pathology and lab medicine as well as the competing economic interests of the …

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Big Lab Industry Stories Reveal Trouble Ahead

CEO SUMMARY: One after another, a series of breaking news stories points to more rough waters ahead for the entire clinical lab industry. Of greatest interest is the ongoing questions about when clinical labs and pathology groups will get paid for the molecular test claims they have submitted to government and private payers since January …

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Labs Have New Hurdles as Some Payments Start

CEO SUMMARY: Some payments are beginning to flow for claims submitted under the new molecular test CPT codes. But there is a new issue. Medicare contractors, Medicaid programs, and private health insurers are deeming certain molecular tests to be medically unnecessary. These payers are requesting that labs submit more documentation before they will pay for …

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Labs Face Consequences from MolDx Test ‘Mess’

CEO SUMMARY: Non-payment of molecular test claims for the first five months of 2013 is not the only financial disruption for labs that perform these tests. Reports are coming in about how Medicare contractors, Medicaid programs, and private payers are declining to pay claims based on rulings that the molecular tests fail to meet medical …

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TriCore Lab Adds Value with Consults, Better TAT

CEO SUMMARY: Motivated by the goal of delivering more value to clinicians and client hospitals, the lab team at TriCore Reference Laboratories in Albuquerque, New Mexico, is proactively introducing new services. One such initiative is to travel to hospitals to participate in rounds and consult with physicians regularly. Another initiative improved the accuracy of C. …

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OIG Tells CMS It Could Save $910 Million on Lab Test Costs

IT IS ONE MORE POWERFUL SIGN of the changing times. Last week, the Office of the Inspector (OIG) publicly released a study it had done of the prices paid for lab testing and how the Medicare program could use this information to reduce the cost of Part B clinical laboratory testing. It was The Wall …

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June 17, 2013 “Intelligence: Late Breaking Lab News”

Big news last week was the unanimous decision by the Supreme Court that natural genes cannot be patented. The case was brought against Myriad Genetics, Inc., by the American Civil Liberties Union, the Association for Molecular Pathology, and several other plaintiffs. The decision invalidated some of the patents held by Myriad for the BRCA 1 …

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