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American Medical Association

Labs, Payers Don’t Like Prior Authorization for Genetic Tests

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UnitedHealth Group Faces DOJ Antitrust Probe

CEO SUMMARY: Recent events have not been kind to UnitedHealth Group and its subsidiaries UnitedHealthcare and Optum. In February, just as UHG’s Change Healthcare division was hit with a major cyberattack that disrupted billions of dolla…

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August 21, 2023, Intelligence: Late-Breaking Lab News

New research about ownership of physician practices will be of interest to anatomic pathologists who operate their own businesses. According to an analysis by the American Medical Association (AMA),…

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How Genomic Testing Labs Can Improve Their Relationships with Payers

CEO SUMMARY: For payers and health plans, it may be a matter of trust that initially curtails speedy reimbursement of new and novel genomic test claims. A panel …

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Coverage, Reimbursement Still Difficult for New Lab Tests

CEO SUMMARY: Bringing a new proprietary diagnostic test to market is an arduous process. It takes patience and planning to complete the journey from test development to payer reimbursement. This slow process stems from the fact that the healthcare reimbursement system is fragmented,…

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Judge Vacates Provision in No Surprises Act

  CEO SUMMARY: It …

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Federal Rule to Revise Out-of-Network Billing

CEO SUMMARY: Remaining out of network with health insurance companies may boost revenue for providers, including anatomic pathologists and emergency room physicians. But the good times may soon end. Last month four federal agencies issued rules that implement new requirements under …

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Memorial Hermann Sells Outreach Lab to Quest

>CEO SUMMARY: Need for more capital is probably one reason why Memorial Hermann Health System decided to sell its large clinical laboratory outreach business to Quest Diagnostics in a transaction both organizations announced on Jan. 27. Although terms of …

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