TAG:
Centers for Medicare and Medicaid Services
Big Employers Sue Payers over Price Transparency
CEO SUMMARY: Feeling they’ve been denied access by insurance companies to price data about medical claim payments, self-funded employer plans and unions are taking their health insurance companies…
Actions Pathologists Can Take to Protect Their Income
CEO SUMMARY: Pathology groups may feel their income is under attack from lower Medicare reimbursement rates and rising practice costs. But steps to protect that income can include carefully determin…
OIG: Billing Code 81408 Is at ‘Risk of Improper Payment’
CEO SUMMARY: Clinical lab executives familiar with molecular test coding and billing will not be surprised to learn that billing code 81408—commonly used on genetic test claims—is at risk of fra…
CMS: TJC Made ‘Business Decision’ to Not Recognize COLA
Following up on a prior briefing, The Dark Report has learned that the Centers for Medicare and Medicaid Services (CMS) does not appear to hav…
UHC’s Z-Code Requirement to Commence on Aug. 1
CEO SUMMARY: In what may be an alarming development for certain clinical laboratories, as of Aug. 1, UnitedHealthcare will require Z-codes for molecular test claims filed under its co…
CMS Ends Remote Reading of Pathology Glass Slides
CEO SUMMARY: On the day the federal government ended the public health emergency for SARS-CoV-2, CMS issued an updated FAQ that ended the allowance for remote reviews of glass slides…
April 17, 2023, Intelligence: Late-Breaking Lab News
There may soon be a new name for the well-known American Association for Clinical Chemistry (AACC). The proposed new name is Association for Diagnostics & Laboratory Medicine (A…
February 13, 2023, Intelligence: Late-Breaking Lab News
Laboratory leaders should prepare now for the end of the federal public health emergency (PHE) for SARS-CoV-2. The White House announced the PHE would cease on May 11. One big change is that patients covered by Medicare, Medicaid, or private insurance may pay higher costs for COVID-19 t…
Joint Commission Will Not Accept COLA Accreditation
CEO SUMMARY: This may be a first in the 40-year history of CLIA accreditation of clinical laboratories. The Joint Commission (TJC) announced it will no longer recognize COLA’s laboratory accreditation program within “TJC-accredited facilities,” effective Jan 1, 2023. COLA-accredited labs …
New CPT Codes Debut for Digital Pathology Services
CEO SUMMARY: New digital pathology CPT codes took effect Jan. 1. Because the new codes are designated as Category III, they are not subject to Medicare and private payer reimbursement yet. Instead, federal health officials will monitor the use of the new codes in 2023 to determine h…
CURRENT ISSUE
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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