June 2014

BRLI-Horizon BCBS Lawsuit Is Window to Payer Actions

CEO SUMMARY: Do “actions speak louder than words?” In New Jersey, one lab company sued a major health insurer for “breach of contract and fraud.” Court documents include claims describing how one health insurer became ever more sophisticated in how it played one public lab company against another in order to drive down its lab […]

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PAMA’s New Rules Affect Lab Test Pricing, Coverage

Laboratory Billing / Joseph Burns

CEO SUMMARY: For several reasons, the “Protecting Access to Medicare Act” (PAMA) has the potential to be the most disruptive federal legislation directed at the clinical lab industry since the enactment of CLIA 1988. Following passage of the law, some lab industry groups have taken different stances toward the positive and negative elements of PAMA.

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Calloway Labs Settles with Feds, West Virginia

Laboratory Compliance / Robert Michel

CEO SUMMARY: West Virginia is the second state in recent years to settle claims of Medicare and Medicaid fraud filed against Calloway Laboratories of Woburn, Massachusetts. Last month, the pain management lab company agreed to pay $4.675 million to resolve that case, while not admitting liability. During the period that Calloway was alleged to have

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‘Game Changer’ Mass Spectrometry for Microbiology at UNC

Laboratory Equipment / Joseph Burns

CEO SUMMARY: Microbiologists at the University of North Carolina are using MALDI-TOF mass spectrometry to slash the time to answer and significantly cut lab costs. Their goals are to improve patient outcomes and reduce average length of stay. In a one-year study presented last month, UNC microbiologists reported that consumable costs for many microbiology tests

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June 09, 2014 Intelligence: Late-Breaking Lab News”

Late Breaking Lab News / Robert Michel

Inpatient utilization has declined in Boston, Indianapolis, and Newark. That’s the finding of a new report issued May 27 by Kaufman Hall, a consulting firm based in Skokie, Illinois. The data was collected by Tufts Medical Center in Boston; Barnabas Health in West Orange, New Jersey; and Community Health Network in Indianapolis. For the 2010-2012

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