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

April 2014

Pathologists Face Unsettling Times

Commentary and Opinion by R. Lewis Dark / By R. Lewis Dark

THESE ARE UNSETTLING TIMES FOR PATHOLOGISTS, particularly those who practice in a private pathology group that serves one or more community hospitals. Blame it on healthcare’s unfolding transformation and the new aggressiveness of payers to cut the prices they pay for anatomic pathology services. At the strategic level, healthcare’s acceptance of integrated care organizations like …

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New Pricing Formula for Advanced Diagnostic Tests

Laboratory Billing / By R. Lewis Dark

CEO SUMMARY: One section of the federal H.R. 4302: Protecting Access to Medicare Act of 2014 is getting positive reviews from many lab experts. The law defines advanced diagnostic tests (ADTs) and directs CMS to assign a temporary HCPCS code and use list prices to pay labs for such tests while it is determining reimbursement …

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Pathologists Top Earners in Medicare MD Pay Data

Pathology Trends / By Joseph Burns

CEO SUMMARY: Never in 50 years had the Medicare program made public the money it pays physicians for Part B services— never until April 9, that is. On that day CMS revealed how it disbursed $77 billion to individual physicians during 2012. Newspapers and television reporters jumped on this story and several pathologists found themselves …

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Labs Face Bad Debt Exposure from New Patients in ACA Plans

Laboratory Billing / By Robert Michel

LABS MAY BE AT RISK for the total cost of lab testing performed for patients who enroll in a subsidized insurance plan through the ACA’s health insurance exchanges (now called the marketplaces), but never pay their premiums during the 90-grace period. The federal Centers for Medicare & Medicaid Services (CMS) allows individuals who buy subsidized …

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Lab Serving Large MD Group Manages Quality and Costs

Laboratory Management / By Joseph Burns

CEO SUMMARY: For decades, pathologists have pointed out that their expertise in laboratory medicine can be tapped by physicians to improve utilization of lab tests, contribute to improved patient outcomes, and reduce the overall cost of care. Exactly that is now happening at Atrius Health, where new value-based reimbursement models and integration of clinical care …

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UCLA Pathologists to Open Joint Venture Lab in Shanghai

Pathology Trends / By Robert Michel

PATHOLOGISTS at the University of California Los Angeles Department of Pathology will participate in a unique commercial laboratory company that will be based in Shanghai, China. On April 8, UCLA announced a partnership agreement with Centre Testing International Corp., in Shanghai, to operate a new clinical laboratory company. CTI is a public company that provides …

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New Skills Needed for Difficult Lab Job Market

Laboratory Management / By Joseph Burns

CEO SUMMARY: Across the nation, a small but growing number of pathologists and lab directors has begun to engage career coaches and management recruiters specifically to sharpen their interviewing and career development skills, even though they are still employed. One expert says this trend reflects today’s tougher job market and recognition that career advancement requires …

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April 28, 2014 Intelligence: Late Breaking Lab News”

Late Breaking Lab News / By Robert Michel

In recent years, a series of decisions involving molecular diagnostics tests made by Medicare officials and the Medicare Administrative Contractors (MACs) have caused much disruption in the clinical laboratory industry. In response to these developments, on April 16, the California Clinical Laboratory Association (CCLA) and a Medicare beneficiary filed a lawsuit against the U.S. Department …

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Congress Raises Stakes in Lab Test Pricing Game

Commentary and Opinion by R. Lewis Dark / By R. Lewis Dark

EACH OF YOU READERS KNOW that there is always a story behind the story. This is particularly true in Congress and the federal government, where lobbying and influence can often have their own role in shaping how laws and regulations are written. Keep that in mind as you learn more about the new law passed …

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Congress’ New SGR Law Has Mixed News for Labs

Laboratory Billing / By Joseph Burns

CEO SUMMARY: Once again, the lab industry faces a mixed bag following passage of a new law by Congress last week. Besides the one-year fix for the SGR, H.R. 4302 also has language that may defer adjustments to Medicare Part B lab test fees until 2017 and creates a new procedure for Medicare officials to …

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