March 2020

OIG 2020 Plan of Work to Review Billing for Medicare Part B Tests

Since October, the federal Department of Health and Human Services Office of Inspector General (OIG) has published two versions of its plan of work for 2020. In both versions, the inspectors highlighted OIG’s efforts to review compliance with Medicare Part B billing requirements for clinical laboratory testing. All clinical labs and pathology groups that bill […]

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COVID-19 Patient? Northwell Has Mobile Phlebotomy App

Clinical Laboratory Trends / Joseph Burns

>CEO SUMMARY: What better way to limit the spread of a deadly novel coronavirus than to allow patients who suspect they have the COVID-19 illness to use a mobile phone to book an appointment with a phlebotomist who makes house calls? Northwell Laboratories started this service in November and now views this option as a

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Northwell Lab Team Validates COVID-19 Test on Fast Timeline

Clinical Laboratory Trends / Joseph Burns

CEO SUMMARY: Clinical labs are working with haste to test for the novel coronavirus, also called nCoV and SARS-CoV-2. Their efforts to prepare for high capacity testing for viral respiratory illness include validating molecular tests for the newly-identified virus and making those tests available for testing patients who may have the COVID-19 illness. At Northwell

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Insurers Are Rejecting Many PLA, MAAA Codes

Laboratory Billing / Joseph Burns

>>CEO SUMMARY: Clinical labs developing innovative tests face a challenge getting paid. While Medicare may reimburse for these tests, some commercial payers and state Medicaid programs are not paying for new proprietary laboratory analyses (PLA) codes and multianalyte assays with algorithmic analyses (MAAA) codes. For labs running these tests, experts say the codes themselves bias

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Healthcare, Lab Market Trends Central Focus at Executive War College

Lab Marketplace / Kristen Noonan

Powerful forces are at work transforming the U.S. healthcare system and the clinical laboratories that serve it. These forces will be identified and discussed at the upcoming 25th annual Executive War College on Lab and Pathology Management, which takes place on April 28-29 in New Orleans. “Without question, the one trend that has the full

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New UnitedHealthcare Policy For Hospital Reference Tests

Laboratory Billing / Joseph Burns

>CEO SUMMARY: Under a new policy UnitedHealthcare will start in May, hospital laboratories will no longer be allowed to bill for reference testing for members who are not hospital patients. The policy is likely to affect clinical lab testing for patients whose testing goes through a hospital’s outreach program. UnitedHealthcare would prefer that all outreach

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Be Careful Payers, You May Get What You Wish For!

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

Few clinical laboratory executives and pathologists would disagree with the assertion that both government and private payers would like to see the prices they pay for medical laboratory testing and the amount of money they spend reimbursing labs to stay flat or shrink from one year to the next. Certainly the actions taken by Medicare

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Northwell Lab Team Validates Novel Coronavirus Test on Fast Timeline

TDR Insider / Mary Van Doren

This is an excerpt of a 2,375-word article in the March 9, 2020 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: Clinical labs are working with haste to develop a novel coronavirus test. In this rare behind-the scenes look, laboratorians can learn about

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