Reliable Business Intelligence News About Clinical Laboratories, Pathology Groups, & Laboratory
Diagnostics Since 1995
The most complete archive of clinical and pathology lab industry news available, including issues from 1997 to the present.
This issue reports that one particular CPT billing code, once dubbed “fraudomatic” by an expert, is responsible for almost $1 billion in “improper” payments. Also, the architect of a one-year digital pathology rollout explains the steps his organization took in achieving this accomplishment.
This issue of The Dark Report continues our coverage of new Z-code mandates for genetic tests, including an in-depth look at technical assessments that may be required. Also, Dartmouth Health explains innovative ways it developed to recruit and retain CLSs, and potential LDT regulation is again gaining steam.
This issue examines the growing need for labs to present data to justify a genetic test earlier in processing of the claim. It also appears that more insurers will start requiring Z-codes for reimbursement of such tests, as UnitedHealthcare now does. In other news, a large laboratory system offers lessons learned on its rollout of the Epic Beaker LIS.
Much lies underneath the surface of UnitedHealthcare’s (UHC) new policy mandating Z-code use for molecular tests covered under its commercial health plans. This development, which creates headaches for many genetic testing companies, is analyzed in depth here. Also, one company shows how data analytics improves lab productivity and TAT.
The Dark Report examines how the acquisition of Geisinger Health by Kaiser Permanente not only sets the stage for more blockbuster hospital deals, but offers a platform for new value-based reimbursement models. Also in this issue, payers are seeking ever more documentation before they’ll pay lab test claims.
The Dark Report analyzes HHS’s draft rule that standardizes digital signatures on test orders, intended to remedy a situation in which payers refuse laboratory test claims on grounds that the ordering provider’s signature is missing or illegible. Also included is a look at the recent OIG opinion on using gift cards to encourage patients to return home-collected samples.
In this issue, The Dark Report outlines six themes at the upcoming Executive War College. These themes show EWC participants what is changing in the healthcare and lab testing sectors, along with effective responses that can advance their lab testing services while generating welcome new sources of revenue. In other news, ARUP Labs and the University of Utah share best practices for winning funding for MT training programs.
Readers will uncover a theme of mergers and consolidations running throughout this issue of The Dark Report. Case in point is our story about the pending merger between Sanford Health and Fairview Health Services. If the deal goes through, the new system will have 58 hospitals across five states. The Dark Report also notes revenues from Labcorp’s acquisition of Ascension Health, and reports on the creation of a major MT training center in Utah.
The Dark Report digs into the pressure facing CAP and The Joint Commission to hire enough inspectors and surveyors. We also look into a Labcorp whistleblower settlement and how Atrium Health’s labs spearheaded cost savings based on pandemic relationships.
The Dark Report explores the decision by The Joint Commission to no longer accept COLA-accredited facilities at its own accredited organizations, and reprints the letters sent by both TJC and COLA relative to the move. In other news, CLIA changes are coming and The Dark Report has an exclusive interview with a member of the committee studying those potential changes.
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Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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