Issue: Volume XXIII No. 9 - July 5, 2016

Is CMS about to Create New Lab Winners, Losers?

FROM ITS INCEPTION IN 1966, THE MEDICARE PROGRAM WAS DESIGNED to give beneficiaries easy access to healthcare services while allowing any qualified provider to provide those clinical services. That is about to change for the worse for many patients and the clinical laboratories that serve them in communities throughout the United States. That bold statement …

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PAMA Final Rule Issued, CMS Plans to Cut Rates by 5.6%

CEO SUMMARY: CMS issued its final rule for implementing the laboratory payment reform included in the Protecting Access to Medicare Act of 2014 (PAMA) on June 17. All labs will see significant reductions to the Medicare Part B Clinical Laboratory Fee Schedule that becomes effective on Jan. 1, 2018. That same section of PAMA requires …

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PAMA Final Rule a Threat To Community Lab Survival

CEO SUMMARY: Will implementation of the final PAMA private payment rate reporting rule for labs put smaller, community labs at financial risk? Yes, says the National Independent Laboratory Association (NILA). By deliberately setting a standard to exclude private payer payment data from hospital outpatient and outreach labs that receive payments off the CLFS, CMS will …

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McKesson, Change Healthcare Decide to Create New Company

ACROSS THE NATION, the hundreds of pathology groups and clinical labs that use McKesson Technology Solutions for their billing and collections, along with labs that use the Advanced Diagnostics Solutions group, should pay attention to a major corporate deal announced June 28. On June 28, McKesson Corporation of New York and Change Healthcare (formerly Emdeon) …

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Florida Pathology Group Lost Volume After BeaconLBS Started

CEO SUMMARY: A 22-physician pathology group in Tampa has complied with rules for lab test ordering that UnitedHealthcare and BeaconLBS established, yet has experienced a steep decline in the volume of specimens it receives. Physicians told the pathologists that other labs were not using the BeaconLBS system or were not asking their clients to use …

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California Lab Company Offers Genetic Tests with Low Prices

ONE BY ONE, A HANDFUL OF PROGRESSIVE LAB COMPANIES is finding financial success with a strategy of pricing genetic tests at levels that are affordable and attractive to the general public. These labs report an added benefit: They find it easier to get health insurers to pay their genetic test claims. This reflects one new …

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July 5, 2016 Intelligence: Late Breaking Lab News

More developments have happened at Theranos, Inc., the beleaguered clinical lab company based in Palo Alto, California. On June 24, Brook Buchanan, Vice President of Communications at Theranos, resigned, giving personal reasons for the decision. Buchanan was hired in November 2015, just seven months earlier. Meanwhile, the press conference that was scheduled for Elizabeth Holmes following …

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New Threat To Community Lab Survival: CMS Clinical Lab Fee Schedule Cuts

This is an excerpt from a 2,000-word article in the July 5 issue of THE DARK REPORT. The original article is available to paid members of the Dark Intelligence Group. CEO SUMMARY: Everyone has read the basic facts, but THE DARK REPORT has gone further to analyze the real-world impact of the final rule from the Protecting …

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