Issue: Volume XVIII No. 16 - November 28, 2011

Molecular Code Stacks Now in the Payers’ Bull’s Eye

LIKE A STEAM BOILER READY TO EXPLODE FROM TOO MUCH PRESSURE, the nation’s health insurers have reached a point of no return on the subject of code-stacked claims for genetic testing and molecular diagnostics assays. Simply put, payers are ready to tackle this sensitive issue. Payers have reasonable questions about this type of clinical lab …

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Palmetto Execs Explain Molecular Test Policies

CEO SUMMARY: To create more transparency in the process clinical labs use to submit claims for genetic tests, molecular diagnostic tests, and for laboratory-developed tests (LDT), the nation’s largest Medicare Administrative Contractor (MAC) has proposed two new local coverage determinations (LCD). CMS has changed Palmetto GBA’s statement of work to include implementing a lab test …

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Palmetto GBA Announces Molecular Test Registry

CEO SUMMARY: Palmetto GBA, the nation’s largest Medicare Administrative Contractor (MAC), is asking labs in the J1 jurisdiction to submit applications for each molecular test they run. Molecular assays will receive a unique five-digit alpha-numeric identifier (Z-code) that will be entered into the narrative/comment field on claims. A panel of subject matter experts will evaluate …

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Rite Aid Offers Free Tests to Preferred Customers

CEO SUMMARY: National pharmacy chain Rite Aid now offers free clinical laboratory tests to members of its customer-rewards program once they reach certain spending levels. After the customer’s specimen is tested, the laboratory test results are sent directly to the customer’s local Rite Aid pharmacist. Next, the pharmacist will discuss the lab test results with …

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New Lab Management Resource for Pathologists, Lab Leaders

FOR PATHOLOGISTS AND OTHERS wanting to sharpen their skills in lab management and administration, there is a new resource. Laboratory Administration for Pathologists has just been published by the CAP Press. It has been long-recognized within the pathology profession that university training emphasizes clinical knowledge and skills. Thus, most pathologists, as they finish their residency …

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Anatomic Path Insourcing Expected to Be Ongoing

CEO SUMMARY: Insourcing of anatomic pathology services by office-based physicians has been especially prevalent and is increasing among three specialties (gastroenterology, urology, and dermatology), according to a survey conducted last month. Survey respondents also indicated that the trend toward increased insourcing is so strong that it could spread to other specialty groups such as ob-gyns …

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Dark Daily

November 28, 2011 “Intelligence: Late Breaking Lab News”

Here’s an interesting window on the true uptake of telemedicine and Internet access. In Oklahoma, the cost of this subsidized service was $28 million in 2009. That cost climbed to $52 million in 2010. Of that total, $19 million was the cost of telemedicine. In Oklahoma City, The Oklahoman newspaper reported that the increase is …

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