Since 1995, Reliable Business Intelligence for Clinical Laboratories, Pathology Groups
and Laboratory Diagnostics
OVER THE PAST 25 YEARS, THERE HAS BEEN WIDESPREAD RECOGNITION THAT HEALTHCARE IN THE UNITED STATES is on an unsustainable path. The obvious argument was that year-over-year increases in healthcare costs would eventually overcome the ability of employers (private health plans) and the government (Medicare and Medicaid) to pay the bill. Yet, 25 years after …
CEO SUMMARY: There was plenty of positive energy last month when the 72nd Annual Scientific Meeting and Exhibition of the American Association of Clinical Chemistry (AACC) took place in Chicago. Attendees seemed pleased to be gathering and networking in person. However, there was recognition that the acute staffing shortage, combined with increasing inflation and deteriorating …
CEO SUMMARY: These are challenging times for the nation’s hospitals, health systems, and clinical labs. A perfect storm involving unprecedented shortages of lab staff, nurses, and other professionals with inflation-fueled cost increases and deteriorating hospital finances was a major topic of discussion by lab leaders and lab vendors at last month’s annual meeting of the …
CEO SUMMARY: In this case study, clinical laboratory managers from Bryan Health in Nebraska explain how they expanded their lab outreach program to include direct-to-consumer tests. The project involved researching what tests were most appropriate without the need for a physician’s order and enlisting the help of various business departments within the health system. FINDING …
CEO SUMMARY: Congress may soon vote on a new bill that permanently reduces the amount of price cuts to Medicare Part B lab test prices, as specified under the Protecting Access to Medicare Act of 2014 (PAMA). The Saving Access to Laboratory Services Act (SALSA) eliminates a 15% payment cut for hundreds of lab tests …
CEO SUMMARY: Bringing a new proprietary diagnostic test to market is an arduous process. It takes patience and planning to complete the journey from test development to payer reimbursement. This slow process stems from the fact that the healthcare reimbursement system is fragmented, with the three main segments being Medicare, Medicaid, and private payers, each …
Coverage, Reimbursement Still Difficult for New Lab Tests Read More »
One of the biggest health insurers in the United States has changed its name. As of June 28, Anthem in Indianapolis, Ind., is now known as Elevance Health. The new name is a combination of “elevate” and “advance,” noted Modern Health Executive on June 16. Elevance also announced Carelon as its new healthcare services brand …
August 8, 2022 Intelligence: Late-Breaking Lab News Read More »
IMPORTANT THINGS ARE HAPPENING WITH COURT DECISIONS AND PROPOSED FEDERAL LEGISLATION that will affect a substantial number of the nation’s clinical laboratories and anatomic pathology groups. In this issue of The Dark Report, you’ll be alerted to those developments we think will have the biggest impact on laboratory compliance and legal risk. The first of …
Important Court Rulings & Pending New Federal Law Read More »
CEO SUMMARY: Just weeks ago, events seemed to indicate that the Verifying Accurate Leading-edge IVCT Development (VALID) Act was going to sail through Congress as part of a bill to reauthorize the FDA. However, momentum has shifted, at least in part because pathologists from academic medical centers spoke up in opposition to the VALID Act. …
CEO SUMMARY: There is a new advisory opinion from the Office of the Inspector General (OIG). It reviewed a proposal in which a clinical lab network would pay fair market value to hospitals for specimen collection based on volume of patients tested. The OIG said this arrangement would violate the federal Anti-Kickback Statute, because hospitals …
New OIG Advisory Opinion Dubious of ‘Fair Market’ Read More »
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