Issue: Volume XXIII No. 15 - November 7, 2016

Test price data shows major difference between Medicare lab fee schedule and private payers

This is an excerpt from a 1,500-word article in the November 7 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. CEO SUMMARY: THE DARK REPORT presents the lab industry’s first look at actual price …

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Medicare Part B Lab Test Prices Versus Budgeted Payment

THERE IS AN IMPORTANT QUESTION THAT lab industry magazines and news sources have failed to address: How many years are left before Medicare officials drop fee-for-service payment for clinical lab testing? On January 26, 2015, the Department of Health and Human Services (HHS) issued a press release declaring an ambitious target. “HHS has set a goal of tying 30% of traditional, …

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10% PAMA Fee Cut Would Lower Medicare Pay to Laboratories by $400 Million

CEO SUMMARY: Just eight weeks remain before certain clinical laboratories must begin submitting private payer lab test price data to the federal Centers for Medicare & Medicaid Services. A new report by the Office of the Inspector General makes it possible to estimate how CMS may implement fee cuts in 2018. THE DARK REPORT’s calculations show that a 10% …

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XIFIN Analysis of Its Real Price Data Shows Hospital Lab Price Effect

CEO SUMMARY: In a new analysis of data its lab clients will use to report market prices to CMS, XIFIN Inc., reports private payers paid independent labs a weighted average price that was 19.6% less than what Medicare pays for 20 of its highest-volume tests. By contrast, private payers paid hospital labs with NPIs a weighted average …

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Market Price Data Sample From: Independent Clinical Labs

Here is the market price data for independent clinical labs from XIFIN Inc. Lâle White, Founder and CEO of XIFIN, discusses the data with THE DARK REPORT. EDITOR: When XIFIN analyzed the actual private payer price data that its independent clinical laboratory clients would report to CMS under the PAMA market price reporting rule, why did …

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Market Price Data Sample from: Hospital Labs with NPI Numbers

Here is the market price data for hospital labs with NPI numbers from XIFIN Inc. Lâle White, Founder and CEO of XIFIN, discusses the data with THE DARK REPORT. EDITOR: The analysis XIFIN has done of hospital lab market price data will be of high interest, not just in the lab industry, but also among legislators and …

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Market Price Data Sample from: Molecular/Genetic Labs

Here is the market price data for molecular and genetic labs from XIFIN Inc. Lâle White, Founder and CEO of XIFIN, discusses the data with THE DARK REPORT. EDITOR: When you did this analysis of molecular and genetic testing labs, what caught your attention WHITE: The issue for us is that Medicare made significant cuts in molecular and genetic test …

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Market Price Data Sample from: Pain Management/Toxicology Labs

Here is the market price data for paint management and toxicology labs from XIFIN Inc. Lâle White, Founder and CEO of XIFIN, discusses the data with THE DARK REPORT. EDITOR: Before we discuss XIFIN’s analysis of what PAMA market price reporting will look like for labs involved in pain management testing and toxicology, I think it is appropriate to recognize …

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