The most complete archive of clinical and pathology lab industry news available, including issues from 1997 to the present.
SOME PATHOLOGISTS AND LAB EXECUTIVES find the FDA’s latest actions regarding pharmacogenetic testing confusing, unclear and beyond the FDA’s authority. Other observers note that the FDA does indeed have a legitimate concern. THE DARK REPORT examines both sides of this controversy. Also reported is the opinion of respected pathology consultants that the result of deep fee cuts by Anthem to some anatomic pathology services will harm patients.
THE DARK REPORT TAKES A DEEP DIVE into the alleged lab fraud case against True Health Diagnostics, which has seen its CMS reimbursement completely cut off, leading the company to file for bankruptcy. The details will help laboratory management understand how a single case of alleged lab fraud affects all labs. Also, TDR is the only lab news source to report on how the leaders of some physician specialties are criticizing Anthem for cutting anatomic pathology professional fees by as much as 70% in states across the nation.
THE MILLENNIAL WORKFORCE BOMB is coming soon to your lab or pathology group, and THE DARK REPORT delivers strategies for attracting, hiring and retaining these newcomers that are vastly different from what has been done in the past. Also, a nightmare-scenario of three patient deaths partly attributed to clinical labs is a warning sign to labs to review their best practices to avoid a similar fate.
MAJOR CHANGES TO ANTHEM’S PATHOLOGY GROUP RELATIONSHIPS include massive cuts of 50-70% in payments. THE DARK REPORT also offers a unique analysis that points to the consequences of another, less-visible change: switching AP groups from its professional services division to its ancillary services division. At the same time, Aetna has decided to end payment to out-of-network pathologists for the professional review of lab tests, which one pathology consulting firm tells TDR could cut some pathology groups’ revenue by as much as $300,000 per year.
THE U.S. HAS LOST ALMOST 18% of its pathologists since 2007. This means the U.S. has even fewer pathologists than other countries who have already suffered adverse clinical lab quality events. TDR also digs further into what this means for the industry, finding that while salaries and benefits are increasing, higher pay will come with a heavier workload. Also, in a Clinical Lab 2.0 case study, TDR walks readers through the steps Northwell Health took to help improve patient care – and add value – by using its data to identify patients who were undiagnosed or misdiagnosed.
IT’S ONE THING TO IMAGINE IT, but another thing altogether to actually achieve it: TriCore Reference Labs demonstrates in this DARK REPORT exclusive how it’s actually making money by selling its data and analytics to insurers. Also, nine clinical laboratory associations and groups are working together to convince CMS to correct serious problems with new guidelines for the National Correct Coding Initiative.
The nation’s largest health insurance provider is set to launch a new preferred laboratory network this summer, and THE DARK REPORT offers news and insights from UnitedHealthCare management on their plans for the PLN. Also, it will be news to many labs that under the new guidelines from the National Correct Coding Initiative, they aren’t being paid for some tests, with denial rates probably ranging from 40 to 100%. TDR talks to a billing expert who says the guidelines affect labs running molecular tests and assays requiring multiple steps.
IT’S A FIRST FOR THE CLINICAL LAB INDUSTRY – and American industry as a whole. This issue exclusively reveals that after two years of testing, a lab has achieved the first revenue-generating flight of an unmanned drone in the U.S. Now, the lab’s transport of supplies and specimens can safely bypass traffic regularly. Remarkably, the project has involved the cooperation of UPS and both the FAA and state regulators. Also, TDR reports that another government initiative, the National Correct Coding Initiative, has apparently gone awry. Labs could be harmed if they submit claims incorrectly based on the NCCI.
THE DARK REPORT offers lab executives and pathologists specific guidance on the arduous process of correctly reporting lab test price data to CMS under the new PAMA rules, so that their organizations can avoid CMS’ $10,000-a-day penalties. Also, an intelligence briefing alerts DARK REPORT clients and readers to a major omission by the Office of the Inspector General in the reports it prepares about the implementation of the PAMA statute.
THE TWO NATIONAL LABORATORIES, LabCorp and Quest, are reporting reduced revenue and operating margins thanks to the PAMA price cuts. At the same time, executives predict higher market share for their companies, and note that as smaller labs fail due to the fee cuts, they’ll be snapped up by larger labs. THE DARK REPORT even extrapolates the devastating financial effects that the PAMA cuts will have on smaller labs, based on the Blood Brothers’ numbers. Also in this issue is an instructive example of a pathology group that gained a prized state contract by focusing its proposal on patient care instead of finances.
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