PLEASE ALLOW ME TO THANK ALL OF YOU READERS who have contacted us with information, rumors, and useful intelligence about UnitedHealthcare’s laboratory benefit management program in Florida that is administered by BeaconLBS, a division of Laboratory Corporation of America. Your input, along with that from physicians in different specialties in Florida and their respective state …
Month: February 2015
CEO SUMMARY: It may not yet be open rebellion, but UnitedHealthcare faces strong opposition in Florida from physicians- and their medical societies-over the requirement that they obtain prenotification and pre-authorization when ordering tests listed in UHC’s laboratory benefit management program. Recent rumors say that UHC has exempted some medical groups from compliance with the program. If true, that could further complicate UHC’s relationship with physicians in the Sunshine State who must continue to comply with this program.
CEO SUMMARY: This is the third installment of THE DARK REPORT’S description of the Laboratory Value Pyramid. It describes “Level Three: Deliver Value that Exceeds Expectations.” This is the level where the laboratory organization now shifts its emphasis from internal operation of the lab to external; to how it contributes added value to its parent hospital and the healthcare community it serves. Level three is where the lab organization can position itself as a recognized contributor to improved patient outcomes that also lower the cost of healthcare.
CEO SUMMARY: An interesting milestone for the clinical lab industry is on the horizon. Physicians Choice Laboratory Services in South Carolina will soon become one of the first lab organizations in the United States to earn joint CLIA and ISO 15189 accreditations with the American Association of Laboratory Accreditation (A2LA). While it was undergoing ISO 15189 accreditation, the organization began to prepare for CLIA accreditation through A2LA, both for a single price.
In the Protecting Access to Medicare Act of 2014 (PAMA), the Center for Medicare and Medicaid Services (CMA) is directed to collect market price data and use the data to establish prices for the Part B Clinical Laboratory Fee Schedule, starting on January 1, 2017.
CEO SUMMARY: Under the Protecting Access to Medicare Act, CMS must collect market price and volume data from certain labs beginning January 1, 2016. CMS will use this data to establish Part B clinical laboratory fees beginning in 2017. One lab association representing community and regional laboratories points out that CMS has complex issues that must be appropriately addressed if the resulting rules are to avoid favoring some types of labs over others, whether intentional or not.
GeneCentric is a new lab testing company in Durham, North Carolina that was started by former executives of Laboratory Corporation of America. It intends to raise $20 million in a Series B capital offering. GeneCentric’s business model is to license molecular diagnostic tests, then develop the clinical trial data required to obtain coverage guidelines and …