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This is an excerpt of a 1,028-word article in the October 5, 2020 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: In this latest lab fraud crackdown, Department of Justice cases involvingĀ clinical labs or molecular test claims may represent about halfĀ (or about $3 …
When you finish reading our story about how MedicareĀ spending for molecular and genetic tests jumped by as much as 700% in certainĀ states during 2019, youāll be among the first in the nation to understand whyĀ a financial crisis is soon to wash over those clinical laboratories and pathologyĀ groups that perform genetic tests. We thank Bruce Quinn, …
CEO SUMMARY: Rapid growth in what Medicare spent forĀ molecular tests in recent years may lead federal investigatorsĀ to increase scrutiny of fraudulent billing for clinical laboratoryĀ and molecular pathology tests, according to a lab consultantĀ who has tracked such spending in recent years. Data show thatĀ Medicare spending for these tests rose sharply since 2017, andĀ that in some Medicare …
Medicare Pays 500% More for Molecular Test Claims Read More »
CEO SUMMARY: Department of Justice cases involvingĀ clinical labs or molecular test claims may represent about halfĀ (or about $3 billion) of the total fraudulent claims. Those claimsĀ stem from genetic testing, urine-drug and other tests, andĀ healthcare services, the DOJ said. In addition, the DOJ reportedĀ that labs were involved in filing fraudulent claims for lab testsĀ while working with …
CEO SUMMARY: Demand for high-complexity mobile coronavirusĀ testing facilities is high, according to the CEO of a start-upĀ company building 25 clinical labs in mobile trailers that can doĀ hundreds of tests per eight-hour day. Employers, schools, eventĀ organizers, and other entities all have high interest in contractingĀ with this California company for mobile on-site testing that canĀ deliver rapid results …
High-Complexity Mobile Labs for COVID-19 Testing Read More »
IT’S BEEN A CHALLENGING YEAR forĀ companies that sell laboratory informationĀ systems (LIS) to the nationās clinicalĀ laboratories. Because of the SARS-CoV-2Ā outbreak, labs have delayed decisionsĀ to acquire or upgrade their existing LISĀ systems, as well as previously-scheduledĀ installs of new or upgraded systems. Two major sellers of LIS products inĀ the United States are Cerner CorporationĀ and Roper Technologiesā SunquestĀ Information Systems. Both …
LIS and Lab Informatics Vendors Report Second Quarter Earnings Read More »
SUBMITTING CLINICAL LABORATORY AND PATHOLOGY TEST CLAIMS toĀ UnitedHealthcare (UHC) will beĀ more complex after the nationās largestĀ health insurer announced three significantĀ changes in its claims processingĀ procedures. The three changes involve: ā¢ Requests for refunds from anatomicĀ pathology (AP) groups that UHC saysĀ may have submitted incorrect claimsĀ for biopsies, ā¢ Rules for out-of-network referrals, and ā¢ More tests needing prior …
UnitedHealth Sets More Billing Rules for Labs, Pathologists Read More »
Guess who will beĀ partnering with theĀ US Department ofĀ Veterans Affairs to supportĀ its wider use of digitalĀ pathology? Itās Google! LastĀ month, it was announced thatĀ the Defense Innovation UnitĀ (DIU) of the Department ofĀ Defense (DoD) had selectedĀ Google Cloud āto prototypeĀ an artificial intelligence-enabledĀ digital pathology solutionĀ to help detect cancer onĀ multiple disease areas.ā ThisĀ relationship can be expectedĀ to encourage acceptance andĀ wider use of digital …
October 5, 2020 Intelligence: Late-Breaking Lab News Read More »
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