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Search Results for: COVID-19

Violating EKRA Earns Lab Owner an Eight-Year Prison Sentence

Laboratory Compliance / By Robert Michel

THIS MAY BE THE MOST HIGH-PROFILE CASE involving a clinical laboratory and the Eliminating Kickbacks in Recovery Act of 2018 (EKRA). Former Arrayit Corporation president Mark Schena was sentenced in October 2023 to eight years in federal prison and ordered to pay $24 million in restitution for his role in a scheme involving healthcare fraud, …

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Payers Are Right to Be Wary of Claims for Some LDTs’ Value

Laboratory Billing / By Virchow

EDITOR’S NOTE: Our column, Virchow, is written by anonymous insiders working within the managed care world. The column aims to help clients of The Dark Report better understand the decisions, policies, and actions of payers as they manage their laboratory networks, establish coverage guidelines, process lab test claims, and audit labs. THERE’S PLENTY OF NOISE …

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Most IVD Firms Increase Q3 2023 Base Business Revenue

In Vitro Diagnostics / By Robert Michel

Most in vitro diagnostics (IVD) companies reported increases in base business during the third quarter (Q3) 2023. The numbers, in the single digits, softened the blow from the continuing drop-off in COVID-19 test sales. Manufacturers of tests and laboratory instruments are launching new diagnostics solutions, making greater use of technology, and eyeing possible acquisitions as …

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Healthcare Fraud Cases Include Decades-Long Cases of Deceit

Laboratory Compliance / By Robert Michel

Healthcare fraud cases continue to receive harsh penalties from the federal government as indicated in the case of a California clinical laboratory owner and her husband who attempted to defraud the government of millions of dollars. Lourdes Navarro and husband Imran Shams attempted to defraud insurances and government entities of $359 million during the COVID-19 …

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Q3 2023 Financial Reports Show Growth at Labcorp, Quest

Clinical Laboratory / By Robert Michel

Blood brothers Labcorp and Quest Diagnostics showed momentum beyond COVID-19 testing and toward areas that grew base business revenue in their third quarter (Q3) 2023 financial reporting. Company leaders called attention to more partnerships and acquisitions of hospital laboratories and outreach lab services. Both companies also launched unique assays—such as blood tests for diagnosis of …

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Proficiency Testing Ranks High as a CLIA Violation

Laboratory Compliance / By Robert Michel

CEO SUMMARY: Proficiency testing (PT) deficiencies are consistently cited by clinical laboratory accreditors during CLIA inspections. Surveyors and inspectors note that labs may mistakenly believe that an 80% score on a PT event is satisfactory. To the contrary, experts advise labs to scrutinize every PT sample that does not pass muster. Editor’s note: This is …

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Clinisys CEO Discusses Strategic Changes Labs Need to Make

IVD/Lab Informatics / By Robert Michel

“Today, we predict that the next storm is about ready to happen, and it will involve clinical laboratories and anatomic pathology practices.” —Michael Simpson CEO SUMMARY: In this exclusive Q&A with The Dark Report, Clinisys CEO Michael Simpson describes the main forces transforming healthcare here in the United States and abroad. He connects these trends …

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How Private Payers Audit Labs for Possible Claims Fraud

Genetic Testing, Lab Risk & Compliance, Laboratory Billing, Laboratory Compliance, Managed Care Contracts, Molecular Diagnostics / By Virchow

EDITOR’S NOTE: Our column, Virchow, is written by different anonymous insiders working within the managed care world. The column aims to help clients of The Dark Report better understand the decisions, policies, and actions of payers as they manage their laboratory networks, establish coverage guidelines, process lab test claims, and audit labs. IN RECENT YEARS, …

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Labcorp and Quest Discuss Outreach Acquisition Potential

Clinical Laboratory Trends, IVD/Lab Informatics, Lab Marketplace, Laboratory Management / By Scott Wallask

GIVEN THE POTENTIAL UPSIDE OF HUNDREDS OF MILLIONS OF DOLLARS IN ADDED REVENUES, both Labcorp and Quest Diagnostics remain on the prowl to acquire more hospital laboratory outreach businesses and seize opportunities to manage inpatient hospital and health system labs. That topic figured prominently into both companies’ Q2 2023 earnings calls with financial analysts. For …

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Private Health Insurers Are Aware of Problems with CPT Code 81408

Lab Intelligence, Lab Risk & Compliance, Laboratory Billing, Laboratory Compliance, Managed Care Contracts / By Virchow

EDITOR’S NOTE: Our column, Virchow, is written by anonymous insiders working within the managed care world. The column aims to help clients of The Dark Report better understand the decisions, policies, and actions of payers as they manage their laboratory networks, establish coverage guidelines, process lab test claims, and audit labs. RECENTLY, THE DARK REPORT …

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