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

September 2014

To Be Paid More, Labs Must Deliver More Value

GETTING PAID FOR LAB TESTS IS BECOMING A MORE URGENT PRIORITY for both clinical laboratories and anatomic pathology groups this year. Multiple factors are responsible for lengthening the collection cycle and reducing overall reimbursement for lab testing. Clients of THE DARK REPORT have followed our coverage of this development. On one hand, payers are getting …

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Wall Street Journal Raises Allegations of Lab Fraud

CEO SUMMARY: Federal investigators are looking into possible violations of the antikickback law by a number of labs offering cardiology tests. The labs under investigation are alleged to have paid physicians processing fees of up to $20 per patient, the Journal reported in a front page story. The labs under scrutiny deny that they violated …

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Did Labs Rip Off Medicare? Feds Are Investigating

CEO SUMMARY: One reason why there is not a level playing field in lab industry compliance with laws governing kickbacks and anti-business behavior is that government officials do not act quickly against the lab industry’s worst offenders—if they take any action at all. News of a federal investigation into the payment of processing fees to …

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Aetna Files Suit against NJ Lab, Plans to Sue Two More Labs

FINALLY, A MAJOR HEALTH INSURER IS taking a hard line against clinical laboratories it suspects of committing fraud. Aetna Health, Inc., and Aetna Life Insurance Company, of Hartford, Connecticut, have sued one lab company and included physicians as defendants in that case. Aetna officials indicate that other lawsuits against labs can be expected. At a …

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Defining a Path to Clinical Laboratory Best-in-Class via Benchmarks

CEO SUMMARY: With the American healthcare system undergoing a major transformation, it is essential that all clinical laboratories and pathology groups recognize this transformation and effect the right strategies to meet the needs of physicians, patients, and payers. A group of lab collaborators proposes a four-level laboratory value pyramid as an effective roadmap to guide …

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Pathologist Raises Questions about Theranos’ Business Model

Dear Editor: I read your two articles on Theranos in the August 11 issue of THE DARK REPORT, and concur in large part with your thoughtful conclusions. For several years, I have closely followed Theranos and have been quoted in trade publications speaking favorably on Theranos and its relationship with Walgreens. Originally, I was attracted …

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September 22, 2014 “Intelligence: Late Breaking Lab News”

Did you know that the world’s longest automation track in a clinical laboratory has just become operational in India? At 93.5 meters (307 feet), it is longer than a football field, according to a press release issued by Siemens Diagnostics. The automation was installed at the central lab of Thyrocare Technologies in Mumbai, India. The …

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Payer Contracts and Labs’ Access to Patients

ONE OF THE MOST SIGNIFICANT TRENDS IN RECENT YEARS is the exclusion of community lab companies and local pathology groups from a growing number of health insurer networks. In simplest terms, if a community lab is denied network provider status by the major payers in its region, it loses access to the patients it needs …

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Philly Blue Cross Contract: LabCorp In; Quest Out

CEO SUMMARY: Independence Blue Cross in Philadelphia decided to select Laboratory Corporation of America for its new eight-year managed care contract that took effect on July 1. However, the real story is the aggressive bidding war between the two national labs. Sources say LabCorp bid an aggressively low price of between $1.00 to 1.60 per …

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In this Philadelphia Story, LabCorp Uses 2007 Script

CEO SUMMARY: There’s a managed care contracting play-book that seems to be working better for Laboratory Corporation of America than it does for Quest Diagnostics Inc. On July 1, LabCorp became the exclusive national lab provider for Independence Blue Cross of Philadelphia. For the past seven years, this contract had been held by Quest Diagnostics. …

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