This is an excerpt from a 2,920-word article in the May 7, 2018 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group.
CEO SUMMARY: In an insightful report, THE DARK REPORT shows how one lab
CEO SUMMARY: Over the 24 months of a first-generation round of laboratory test utilization management projects, the Cleveland Clinic laboratories prevented more than 30,000 duplicate or inappropriate test orders, saving almost $2.7 million. Now implementing a second-generation of labtest utilization projects, the lab’s seven-year effort has prevented 160,072 tests and saved more than $5 million.
CEO SUMMARY: Just as Nero is reputed to have fiddled while Rome burned, officials at CMS seem to be doing their own fiddling as their planned deep price cuts to Medicare Part B lab tests could begin driving lab companies out of business. In recent weeks, the owners of two lab companies decided to sell
CEO SUMMARY: Once Anthem and UnitedHealthcare establish their respective genetic test prior-authorization programs, a new era for genetic testing will commence. The 80 million beneficiaries served by these two payers make up half of the individuals who have private health insurance. It is reasonable to expect that other health insurers will follow the lead of
RECENT DEVELOPMENTS SIGNAL THAT THE FIGHT over FDA regulation of laboratory-developed tests (LDTs) is about to intensify. Last month, two Congressional representatives announced a new bill about LDTs that they said was a “discussion draft.” The bill is titled the “Diagnostic Accuracy and Innovation Act (DAIA).”
CEO SUMMARY: Arizona’s new direct access testing law allows consumers and patients to have access to all laboratory tests without a physicians’ order. But one lab company decided not to offer all lab tests to consumers. Instead, executives at Sonora Quest Laboratories recognize that, for some health conditions that are complex to diagnose, it is
CEO SUMMARY: Some physicians in Florida are not complying with UnitedHealthcare’s laboratory benefit management program since the claims impact took effect on April 15. Although officials from UnitedHealthcare and BeaconLBS, a business division of LabCorp, state publicly that the program is going well, physicians and several state medical associations continue to voice serious objections to several key elements of UnitedHealthcare’s lab test utilization management program.
CEO SUMMARY: Across the nation, hospital administrators are recogniz- ing that effective lab test utilization is a critical factor in a lab’s success. At Seattle Children’s Hospital, clinical pathologists, clinical chemists, and labora- tory genetic counselors are using an innovative utilization management pro- gram to ensure the appropriate use of genetic and molecular tests. They also formed Pediatric Laboratory Utilization Guidance Services. In two years, PLUGS has gained 32 members, including seven hospital labs serving adults. Interest in utilization management is driven by a desire to decrease test order- ing errors and to control the cost of send-out tests.
CEO SUMMARY: Over the past 18 months, Theranos has taken steps to enter the clinical lab marketplace. Across Greater Phoenix, Theranos now has specimen collection centers in about 40 Walgreens pharmacies. It is opening a CLIA lab facility in Scottsdale. Now that it is delivering clinical laboratory testing services on a regular basis, the quality of its laboratory test results and the service it provides to physicians and patients will get close scrutiny from both investors and competing labs.
CEO SUMMARY: Widespread frustration continues within the independent clinical laboratory community about the new Blue Card rules that took effect in October 2012. That was when the Blue Cross Blue Shield Association revised its Blue Card program so that labs must bill the local plan in the service area where the specimen was obtained/collected. Further,