No Surprises Act Sparks a Slew of Court Decisions

By Scott Wallask | From the Volume XXX, No. 13 – September 11, 2023 Issue

CEO SUMMARY: Multiple lawsuits filed by the Texas Medical Association against the federal government have resulted in key decisions that affect provisions in the law. Qualifying payment amounts and …

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PAMA Cuts Have Simply Been Kicked Down the Road

By R. Lewis Dark | From the Volume XXX, No. 1 – January 3, 2023 Issue

PAYMENT RATE CUTS FOR CLINICAL LABORATORY TESTS, called for under the Protecting Access to Medicare Act of 2014 (PAMA), have been avoided temporarily—again.  A down-to-the-wire bill in Congress to keep the federal government funded into the new year in…

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Congress Averts PAMA Cuts to Lab Test Rates for 2023

By Scott Wallask | From the Volume XXX, No. 1 – January 3, 2023 Issue

CONGRESS ENACTED LEGISLATION LAST MONTH that suspends implementation of the next round of price cuts to the Medicare Part B Clinical Laboratory Fee Schedule (CLFS) that was scheduled to take effect on Jan. 1. This is a welcome development for the medical laboratory industry….

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2022’s Top 10 Lab Stories Confirm Challenging Times

By Scott Wallask | From the Volume XXIX, No. 17 – December 12, 2022 Issue

CEO SUMMARY: There are valuable insights to be gleaned from The Dark Report’s “Top 10 Lab Industry Stories for 2022.” Several of this year’s story picks involve external forces reshaping healthcare in the United States in profound ways. Other story picks for 2022 illustrate …

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VALID and SALSA Acts Still Pending in Congress

By Scott Wallask | From the Volume XXIX, No. 16 – November 21, 2022 Issue

CEO SUMMARY: Both the pending VALID Act and SALSA Act continue to push ahead as 2022 comes to an end. Meanwhile, a new bill centered on the Physician Fee Schedule may protect pathologist payments. These three different proposals share something in common:…

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On Appeal, ACLA Gains PAMA Victory in Court

By Scott Wallask | From the Volume XXIX, No. 12 – August 29, 2022 Issue

CEO SUMMARY: Last month, a U.S. Court of Appeals issued a ruling that criticized how the Department of Health and Human Services originally implemented the Protecting Access to Medicare Act of 2014 (PAMA). This ruling was a win for the American Clinical Laboratory Association in its…

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PAMA Cuts Might Be Reduced to Zero for 2023

By Scott Wallask | From the Volume XXIX, No. 11 – August 8, 2022 Issue

CEO SUMMARY: Congress may soon vote on a new bill that permanently reduces the amount of price cuts to Medicare Part B lab test prices, as specified under the Protecting Access to Medicare Act of 2014 (PAMA). The Saving Access to Laboratory Services Act (SALSA) eliminates a 15% paym…

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Coverage, Reimbursement Still Difficult for New Lab Tests

By Robert Michel | From the Volume XXIX, No. 11 – August 8, 2022 Issue

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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Labcorp to Buy Outreach, Manage Ascension Labs

By Robert Michel | From the Volume XXIX, No. 3 – February 22, 2022 Issue

CEO SUMMARY: In a blockbuster deal valued at almost half a billion dollars, Labcorp will manage dozens of hospital labs in 10 states on behalf of Ascension Health, one of the biggest health systems in the country. Labcorp will also spend $400 million to acquire certain assets of Asc…

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Non-COVID Part B Lab Spend Declined by 15.9% in 2020

By Robert Michel | From the Volume XXIX, No. 2 – January 31, 2022 Issue

MEDICARE PART B CLINICAL LABORATORY FEE SCHEDULE CUTS mandated by PAMA continue to bite deeply. A new government report shows that during fiscal 2020, the Medicare program spent 15.9% less for lab tests, when COVID-19 test payments are excluded.  The fed…

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