Since 1995, Reliable Business Intelligence for Clinical Laboratories, Pathology Groups and Laboratory Diagnostics

Volume XXX, No. 10 - July 10, 2023

UHC Z-code Deadline Looms, Raising Concerns About Technical Assessment Timelines

By now, many of you are aware that UnitedHealthcare is scheduled to begin requiring Z-codes for genetic test claims under its private health plans. That Aug. 1 deadline raises questions about whether labs that need to complete a technical assessment as part of their Z-code requests will have enough time for a review. Experts weigh …

UHC Z-code Deadline Looms, Raising Concerns About Technical Assessment Timelines Read More »

To access this post, you must purchase The Dark Report.

July 10, 2023, Intelligence: Late-Breaking Lab News

General health panels submitted under CPT code 80050 are among the most expensiveā€”and potentially most wastefulā€”diagnostic tests, according to a new study published in June byĀ Avalon HealthcareĀ Solutions in Tampa, Florida. These panels include a metabolic panel, complete blood count, and thyroid stimulating hormone level. Avalon reported that 80050 is likely a prime example of ā€œpanel …

July 10, 2023, Intelligence: Late-Breaking Lab News Read More »

To access this post, you must purchase The Dark Report.

Cyberattack Victims Sue Enzo Biochem and Labcorp

CEO SUMMARY: Itā€™s the latest reminder that clinical laboratories and anatomic pathology groups are at risk for two threats. One threat is a cyberattack that shuts down a labā€™s IT system while stealing patient data. The other threat involves lawsuits against the same lab by patients unhappy that their protected health information was stolen by …

Cyberattack Victims Sue Enzo Biochem and Labcorp Read More »

To access this post, you must purchase The Dark Report.

FDA Expected to Publish Proposed LDT Rule in August

CEO SUMMARY: Congressional lawmakers and the federal Food and Drug Administration are again eyeing changes that would bring greater oversight to laboratory-developed tests (LDTs). Leaders at clinical laboratories and pathology groups should monitor these proposals, both of which could have long-term ramifications for labs that use LDTs. Action to increase regulatory oversight of laboratory-developed testsĀ (LDTs) …

FDA Expected to Publish Proposed LDT Rule in August Read More »

To access this post, you must purchase The Dark Report.

HCCI Reports Higher Prices for Hospital Outreach Tests

CEO SUMMARY: Itā€™s another shot across the bows to hospital and health systems that use inpatient test prices when billing health insurers for outpatient/outreach lab tests. In its report, the Health Care Cost Institute documents how these hospital lab outreach programs price their tests from three to five times higher than independent labs and POLs. …

HCCI Reports Higher Prices for Hospital Outreach Tests Read More »

To access this post, you must purchase The Dark Report.

Dartmouth Health Lab Recruits and Trains More CLSs

CEO SUMMARY: Keeping clinical laboratories fully staffed may be the single biggest issue confronting labs today. In New Hampshire, the lab team at Dartmouth Health crafted an innovative program that pays students as they pursue their clinical laboratory scientist certification. In return, these students agree to a multi-year commitment to work at the Dartmouth Lab. …

Dartmouth Health Lab Recruits and Trains More CLSs Read More »

To access this post, you must purchase The Dark Report.

Technical Assessment Challenges for Z-Code Applications

CEO SUMMARY: Effective on Aug. 1, UnitedHealthcare will require Z-code submissions for many genetic tests. During a recent webinar, experts tackled a topic that may prove troublesome for labs seeking Z-codes: technical assessments. Key advice is to provide specific data about clinical validity and clinical utility of a novel genetic test. UnitedHealthcareā€™sĀ (UHC) new requirementĀ that as …

Technical Assessment Challenges for Z-Code Applications Read More »

To access this post, you must purchase The Dark Report.

UnitedHealthcareā€™s Z-code Policy Starts on Aug. 1

CEO SUMMARY: UnitedHealthcareā€™s (UHC) response to the ever-growing number of unique genetic tests and the continuing growth in the volume of those claims is a new policy. Effective Aug. 1, UHC will require a Z-code with genetic test claims. This requirement means labs serving UHC beneficiaries need to obtain a Z-code for their genetic tests. …

UnitedHealthcareā€™s Z-code Policy Starts on Aug. 1 Read More »

To access this post, you must purchase The Dark Report.

Stressful Weeks Ahead for Labs Thanks to Z-codes

We are not alone in recognizingĀ thatĀ UnitedHealthcareā€™sĀ (UHC) upcoming mandate for Z-code use in genetic test claims has the potential to be disruptive to many clinical laboratories. Evidence of this widespread concern was provided on June 29. Thatā€™s the day thatĀ The Dark ReportĀ hosted a webinar titled, ā€œEssential Guide to Obtaining Z-codes for Molecular and Genetic Tests.ā€ Nearly …

Stressful Weeks Ahead for Labs Thanks to Z-codes Read More »

To access this post, you must purchase The Dark Report.

;