Month: August 2019

After Two-Year Battle with CMS, True Health Diagnostics on Verge of Collapse

This is a synopsis of three in-depth articles in the Aug. 12, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group. CEO SUMMARY: In 2017, an auditor for CMS alleged that True Health Diagnostics filed fraudulent claims and the federal Medicare program cut all payments …

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How Lab Fraud Hurts Hospital Labs, Pathologists

ONCE AGAIN, A HIGH-PROFILE LAB COMPANY faces allegations of fraud and abuse. This time it is True Health Diagnostics of Frisco, Texas. Details of this case were revealed last month when True Health filed a lawsuit in a federal court in Texas against the agencies running the federal Medicare program. In its lawsuit, True Health …

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Dermatologists Say Anthem Cuts Affect Patient Care

CEO SUMMARY: Deep cuts in what Anthem pays pathologists for the professional component for certain AP services are having a harmful effect on the long-standing relationships that dermatologists have with dermatopathologists, some physicians say. By disrupting these relationships, Anthem is harming patient care, they add. Since late last year, in a growing number of states, …

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Is Pathology Workforce Stable or Shrinking?

CEO SUMMARY: After publishing research in JAMA Network Open showing a coming shortage of pathologists in the United States, the researchers heard from pathologists whose experience in the job market did not match what the researchers found. Anecdotal evidence indicates that the demand for pathologists may vary widely from region to region and in urban …

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In New Mexico, Three Collaborators Improve Patient Care, Outcomes

IT’S OFFICIAL! A YEAR-LONG COLLABORATION involving a health insurer, a clinical laboratory, and an analytics company showed that insurers and physicians can use clinically-actionable intelligence developed from medical lab test data to improve patient outcomes. This important accomplishment in patient care comes with another significant milestone: The health insurer is paying the lab outside of …

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After Two-Year Battle with CMS, True Health on Verge of Collapse

CEO SUMMARY: In 2017, an auditor for CMS alleged that True Health filed fraudulent claims and the federal Medicare program cut all payments to the lab company and one month later reduced the cut to 35% of the billed amount. Two months ago, CMS ended all payments again. These facts became public on July 2 …

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ACLA Gets Procedural Win in Its Appeal of PAMA Case

IN A SIGNIFICANT WIN for the American Clinical Laboratory Association (ACLA) and other groups suing federal Department of Health and Human Services (HHS), the U.S. Court of Appeals for the District of Columbia ruled in the ACLA’s favor on July 30. Ruling on the appeal in the case the ACLA brought against HHS Secretary Alex …

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August 12, 2019 Intelligence: Late Breaking Lab News

Add eight more laboratories to the list of lab companies whose patient data were breached when the American Medical Collection Agency was hacked. According to HealthITSecurity, in recent weeks, these labs reported breaches of their patient records: Natera American Esoteric Labs CBLPath South Texas Dermatopathology Seacoast Pathology Arizona Dermatopathology Laboratory of Dermatopathology ADX MORE ON: Patient Data …

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