Issue: Volume XXI No. 12 - September 2, 2014

Payer Contracts and Labs’ Access to Patients

ONE OF THE MOST SIGNIFICANT TRENDS IN RECENT YEARS is the exclusion of community lab companies and local pathology groups from a growing number of health insurer networks. In simplest terms, if a community lab is denied network provider status by the major payers in its region, it loses access to the patients it needs …

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Philly Blue Cross Contract: LabCorp In; Quest Out

CEO SUMMARY: Independence Blue Cross in Philadelphia decided to select Laboratory Corporation of America for its new eight-year managed care contract that took effect on July 1. However, the real story is the aggressive bidding war between the two national labs. Sources say LabCorp bid an aggressively low price of between $1.00 to 1.60 per …

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In this Philadelphia Story, LabCorp Uses 2007 Script

CEO SUMMARY: There’s a managed care contracting play-book that seems to be working better for Laboratory Corporation of America than it does for Quest Diagnostics Inc. On July 1, LabCorp became the exclusive national lab provider for Independence Blue Cross of Philadelphia. For the past seven years, this contract had been held by Quest Diagnostics. …

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Emmanuel Farber Dead at 95, First to Describe Carcinogenesis

ONE OF THE PATHOLOGY PROFESSION’S MOST RESPECTED cancer researchers died last month. On August 3, Emmanuel Farber, M.D., passed away. He was 95 years old. Farber was noted for his work in furthering the understanding of chemical carcinogenesis. His studies in experimental pathology revealed that chemical carcinogens can bind to nucleic acids, which could then …

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UnitedHealthcare, BeaconLBS Respond with Statements

IN FLORIDA, BOTH CLINICAL LABS and physicians have expressed concerns UnitedHealthcare’s Laboratory presented in full on this page and the following page. about Benefit Management Program that formally becomes effective on October 1. From that date forward, physicians will be required to obtain advance notification or pre-authorization for 81 tests. Following our request for comment …

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Florida Doctor Questions Lab Test Pre-notification

CEO SUMMARY: An interesting tug-of-war may develop in Florida between a major health insurer and physicians. UnitedHealthcare will require physicians to obtain a pre-notification number for 81 lab tests by using the BeaconLBS system (developed by a subsidiary of LabCorp). One family practice physician is speaking out about his concerns that the new UHC requirement …

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Longer Pay Cycle for Labs, Plus Lower Collection Rate

CEO SUMMARY: Across the United States, clinical labs, histology labs, and pathology groups are experiencing both a much longer payment cycle for claims and a decreased gross collection rate. Blame can be placed on several trends. One trend is the steady increase in the number of patients with high-deductible health plans. Another trend involves payers …

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Dark Daily

September 02, 2014 “Intelligence: Late- Breaking News”

There will be one less vendor of laboratory information systems (LIS) when a major acquisition is completed. Last month, Siemens AG announced that it would sell Siemens Health Services to Cerner Corp. for a price of $1.3 billion. Analysts believe that Cerner was motivated to do the deal because, among other benefits, it would gain …

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