Issue: Volume XXV No. 4 - March 5, 2018

Two Major, Disruptive Changes Coming to Labs

TWO MAJOR, DISRUPTIVE CHANGES lie ahead for both clinical laboratories and anatomic pathology group practices. Each disruptive factor has nothing to do with how payers select in-network labs or reimburse for lab testing services. Rather, one of these two major changes involves fundamental advances in the diagnostic technologies used by labs to diagnose disease and …

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Anthem Seeks $13.5M from California Hospital

CEO SUMMARY: Anthem charged 37-bed Sonoma West Medical Center in Sebastopol, Calif., of engaging in an improper billing scheme to defraud Anthem and its affiliated Blue Cross and Blue Shield plans. In effect, the charge is a notification to SWMC that Anthem intends to sue SWMC and its owner if it does not recover the $13.5 million in a timely …

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Hospital Board Expressed Doubts about Lab Billing

CEO SUMMARY: Pass-through billing arrangements, particularly those involving clinical laboratory tests, have long been recognized by healthcare attorneys as having great potential to violate certain federal and state laws. Despite this fact, board members of a financially-struggling community hospital went forward with a pass-through billing agreement that news accounts says committed the hospital to pay …

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LAB BRIEFS

DUBAI TO TEST DNA OF ITS 3 MILLION CITIZENS RECENTLY, GOVERNMENT OFFICIALS in Dubai announced a plan to conduct genetic testing on all three million residents. Experts say this is an unprecedented decision by any national government. This human genome project will be part of the Dubai 10X initiative. “The authority is looking to target all …

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ACLA Sues HHS, Claims Flaws In How CMS Set 2018 Rates

CEO SUMMARY: When the American Clinical Laboratory Association filed its lawsuit Dec. 11 against the Secretary of Health and Human Services, one of its main claims is that HHS collected payment data on the clinical laboratory testing business in a manner that was deeply flawed. HHS then used that flawed data to set payment rates …

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Sale of Tox Lab Company Attracted Multiple Buyers

CEO SUMMARY: In the midst of expanding their toxicology testing services nationally, DrugScan and DSI Medical Services (collectively Toxicology Holdings Inc.) hired a brokerage firm last year to pursue a sale of the two toxicology companies. Multiple potential buyers responded with interest. The buyer, ACM Global Laboratories—owned by a health system in Rochester, N.Y.—saw the …

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March 5, 2018 Intelligence: Late Breaking Lab News

“More people took genetic ancestry tests last year than in all previous years combined,” declared Senior Editor Antonio Regalado in a story published on Feb. 18 by MIT Technology Review. He wrote that, just in 2017, the number of people who had their DNA analyzed with direct-to-consumer genetic genealogy tests more than doubled. According to …

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