Issue: Volume X No. 16 - December 1, 2003

ABNs, Client Billing, “Free Testing? & Medicare Rules

BY ANY MEASURE, ENFORCEMENT ACTIONS by the Office of the Investigator General (OIG) for Medicare fraud and abuse within the laboratory testing industry was a big story during the 1990s. I wonder if we might not be at a crossroads that could take our profession down a similar path in this decade. There are interesting …

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“Free Testing” Strategy Stirs the Pot in Tenn.

CEO SUMMARY: In Tennessee, the state’s Medicaid HMO plan has been at odds with Quest Diagnostics Incorporated, which is using the “free testing” strategy to expand its share of the market. In recent months, TennCare Select has taken active steps to insure its physicians understand that Quest Diagnostics is not a contract provider for “included …

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“Waiver of Charges”: What Makes It Work

CEO SUMMARY: Little-used in the 1990s, when laboratory test ordering and billing practices were under intense scrutiny by federal regulators, the strategy of “free testing” is popping up in more regions around the country. To comply with compliance guidelines, labs using this strategy generally ask the physician to sign contracts representing and warranting that circumstances …

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Lab Marketing Strategy Triggers Legal Concerns

CEO SUMMARY: That famous phrase “everyone wants something for nothing” does not describe TennCare Select’s reaction to the “free testing” that Quest Diagnostics is performing for its beneficiaries. TennCare provides a real-world example of how this strategy can put a laboratory at odds with an important payer in a region. An experienced healthcare attorney assesses …

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Where Will “Free Tests” Take the Lab Industry?

CEO SUMMARY: In the absence of public discussion, continued use of the “free testing” strategy by the nation’s more aggressive laboratory companies could trigger some unpleasant consequences that would affect all laboratories and pathology group practices. Five questions, presented here, illustrate how private and public healthcare payers might react to the ongoing use of “free …

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“December 1, 2003 Intelligence: Late Breaking Lab News”

Lab-Interlink Inc. of Omaha, Nebraska is heading to bankruptcy court. On November 24, the day before Thanksgiving, the company laid off 50 employees. Rodney Markin, M.D., Ph.D., Company founder and Chairman stated that an expected $1 million payment by a prospective buyer had not materialized that day. The money was to have covered payroll and …

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