Labs May Be Excluded from Revised Stark, AKS Rules

By Joseph Burns | From the Volume XXVII No. 1 – January 6, 2020 Issue

CEO SUMMARY: When CMS and the OIG issued proposed rules last fall to make it easier for providers to participate in value-based and coordinated care arrangements, they considered excluding clinical labs, pharma companies, and DME firms because of concerns that the proposed rules could pro…

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Labs May Be Excluded from Revised Stark Law, AKS Rules

By Mary Van Doren

This is an excerpt of a 1,460-word article in the Jan. 6, 2020 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: Here are early insights about a federal compliance reform that has not gotten much attention among clinical la…

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How Labs Can Add Value for Providers, Insurers, Pharma

By Joseph Burns | From the Volume XXVI No. 15 – November 4, 2019 Issue

CEO SUMMARY: For pathologists and clinical, molecular, and genetic testing labs, appropriate reuses of lab data can provide a new source of revenue. Labs that serve as preferred providers of diagnostic testing data can help health systems, ordering physicians, pharmaceutical companies, an…

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Strategist Explains Key Trends in Healthcare’s Transformation

By Joseph Burns | From the Volume XXVI No. 14 – October 14, 2019 Issue

CEO SUMMARY: Four trends are disrupting the nation’s healthcare system in ways that no one would have predicted just a few decades ago. Ted Schwab, a healthcare strategist, described these trends during his keynote presentation at the 24th Annual Executive War College in May. His insig…

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ASCP, CAP Ask Anthem to Roll Back Price Cuts

By Joseph Burns | From the Volume XXVI No. 13 – September 23, 2019 Issue

CEO SUMMARY: One association representing pathologists says new payment rates that Anthem, Inc., is introducing in 14 states do not cover the costs of performing anatomic pathology and clinical lab testing for the tests in question. Another association says the steep payment cuts threaten…

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Dermatologists Say Anthem Cuts Affect Patient Care

By Joseph Burns | From the Volume XXVI No. 11 – August 12, 2019 Issue

CEO SUMMARY: Deep cuts in what Anthem pays pathologists for the professional component for certain AP services are having a harmful effect on the long-standing relationships that dermatologists have with dermatopathologists, some physicians say. By disrupting these relationships, Anthem i…

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Anthem Rolling Out More Anatomic Path Price Cuts

By Joseph Burns | From the Volume XXVI No. 9 – July 1, 2019 Issue

CEO SUMMARY: Anthem is making big changes to its relationships with anatomic pathology groups. Getting most of the attention at the moment are the insurer’s letters announcing price cuts for anatomic pathology services of 50% to 70% of Medicare fees. But another major change may also tr…

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Anthem Rolling Out New Pathology CPT Code Cuts

By Mary Van Doren | From the Volume XXVI No. 9 – July 1, 2019 Issue

This is a synopsis of a 2,120-word article in the July 1, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group.  CEO SUMMARY: Anthem is making big changes to its relationships with anatomic pathology (AP) groups. Getting most o…

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AP Groups Can Protect Revenue, Pathologist Compensation

By Joseph Burns | From the Volume XXVI No. 5 – April 8, 2019 Issue

CEO SUMMARY: Many anatomic pathology groups are watching their revenue decline and margins shrink on the same or greater case volume. These trends make it imperative to have a deeper understanding of the operational and financial variables that contribute to stability in the group’s fi…

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Sonic to Pay $540 Million to Buy Aurora Diagnostics

By Joseph Burns | From the Volume XXV No. 18 – December 24, 2018 Issue

CEO SUMMARY: Sonic Healthcare, Ltd., announced that it would pay $540 million—a multiple of 9.2 times EBITDA—to acquire Aurora Diagnostics, the anatomic pathology company based in Palm Beach Gardens, Fla. Sonic will gain 32 pathology practice sites and add 220 pathologists to its netw…

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