August 2015

Is New Cycle of Laboratory Fraud Plaguing the Industry?

CEO SUMMARY: Taken collectively, the growing number of federal investigations of lab companies and health insurer lawsuits against lab companies alleging fraudulent business practices signals a disturbing new trend for the lab industry. In THE DARK REPORT’s typical hard-hitting analysis of an emerging clinical laboratory trend, it is noted that while these allegations are leveled at just a handful of […]

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LabCorp Loses A Hospital Lab Joint Venture

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

ONE OF THE NATION’S LONGEST-RUNNING LAB OUTREACH JOINT VENTURES involving a public lab company and a major hospital came to a quiet end on June 30. That’s the day when United/Dynacare Laboratories, LLC, ceased to exist.

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Is New Cycle of Fraud Plaguing Lab Industry?

Laboratory Compliance / Robert Michel

CEO SUMMARY: Taken collectively, the growing number of federal investigations of clinical lab companies and health insurer lawsuits against lab companies alleging fraudulent business practices signals a disturbing new trend for the lab industry. Although these allegations are leveled at just a handful of lab companies, the amount of money these labs took out of the system exceeds a billion dollars. Some experts expect payers will enact tough requirements to stop such abuses.

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Cigna Audits Tox Test Labs For Proof that Patients Paid

Laboratory Billing / Joseph Burns

CEO SUMMARY: In an unusually strong move, health insurer Cigna is auditing laboratories, including some labs that do toxicology testing. In these audits, the health insurer seeks documentation that the testing is medically necessary and that the laboratories are collecting copayments and deductibles from patients before Cigna pays the labs for the toxicology test claims. A lawyer working on these cases says that tactic may violate some state prompt-payment laws.

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Lab Briefs

Laboratory Compliance / Robert Michel

LAST WEEK, A CALIFORNIA JUDGE APPROVED the settlement of a lawsuit that claimed Quest Diagnostics Incorporated had violated a state law that forbids selling services (in this case, lab testing) below cost.

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Detroit Hospital Develops 10 Ways To Add More Value

Clinical Laboratory / Joseph Burns

CEO SUMMARY: Clinical labs are beginning to make the transition from a volume-based financial model to a model based on value-based payments. To survive this transition, labs must find ways to create value. The lab at Henry Ford Health System has identified 10 ways that it can contribute more value to physicians and its parent health system. One way is to help eliminate needless tests and processes. Other initiatives involve improving supplier processes, helping to reduce patient length of stay, creating a lab test formulary, and demonstrating the financial efficacy of all lab interventio

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More AP Consolidation: Aurora Buys Two Groups

Anatomic Pathology / Joseph Burns

CEO SUMMARY: Seeing the changes overtaking pathology practices, Brazos Valley Pathology decided to sell two of its group practices to Aurora Diagnostics. Last month’s transaction was not designed to fix financial problems nor was it because of retiring pathologists. Rather, it was done proactively to ensure that BVP’s 11 pathologists had access to the resources of a larger pathology organization so that they could expand or add technology as needed in the future, while practicing independently.

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August 24, 2015 Intelligence: Late Breaking Lab News

Late Breaking Lab News / Robert Michel

California is always in the forefront of states doing innovative things. It announced a public-private effort to develop a clinical lab- oratory assay that “will enable detection of all known pathogens with a single DNA sequencing test, to diagnose acute infections in hospitalized patients.”

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New company ready to heat up slow digital pathology market

TDR Insider / Mary Van Doren

IN THE 2000S, DIGITAL PATHOLOGY WAS THE HOT NEW TECHNOLOGY that held great potential to transform anatomic pathology in myriad ways, not the least of which was an essential tool to streamline pathologist workflow while supporting greater diagnostic precision. Yet today, approximately 10 years later, those high hopes for the digital pathology market have not

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Collecting Big Patient Deductibles

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

THERE HAS BEEN EXPLOSIVE GROWTH IN THE NUMBER OF PATIENTS enrolled in high- deductible health plans. Currently, more than 20 million people have HDHPs. This is one reason why many labs are experiencing high levels of patient bad debt never before seen by the lab industry during the past three decades.

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