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January 5, 2015 Intelligence: Late Breaking News

In Vermont, a multi-year effort to create a statewide single-payer health insurance program has failed. On December 17, Governor Peter Shumlin announced that the state would not go forward with its plans to create a health program called Green Mountain Care. “The bottom line is that… it b…

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Top 10 2014 Biggest News Stories

Story no.1 SGR Fix by Congress Spawns PAMA; Lab Industry Wary of Law’s Impact ON APRIL 1, PRESIDENT BARACK OBAMA signed into law the Protecting Access to Medicare Act of 2014 (PAMA). As written, it has the potential to be the most impactful federal legislation on the clinical lab industry s…

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More Genetic Counseling Leads to Fewer Lab Tests

CEO SUMMARY: Cigna was the first national health insurer to require independent board-certified genetic counseling before approving coverage for certain genetic tests. Since launching this program in September 2013, the insurer has seen a 450% increase in genetic counseling for Cigna …

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Level Two of Value Pyramid Defines Internal Benchmarks

CEO SUMMARY: In this second installment of our series on the laboratory value pyramid, we introduce “Level Two: Establish and Meet Standards of Value.” This second level continues the lab’s focus on its internal operations and activities. The goal is for the lab to develop the working cultu…

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Alberta Picks Sonic Health for $3 Billion Lab Contract

CEO SUMMARY: For more than a year, Alberta’s C$3 billion RFP to develop an integrated laboratory testing service for Edmonton and surrounding regions has been the focus of intense interest. On October 17, health officials announced that Sonic Healthcare Limited was the preferred propone…

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FL Docs Say: ‘No Thanks’ to UHC and BeaconLBS

CEO SUMMARY: Some Florida physicians are declaring their intent to leave UnitedHealthcare’s network because they find the insurer’s new BeaconLBS laboratory benefit management system to be time consuming and onerous. The defections come as the program goes through a soft launch that b…

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Physicians and Labs Wary of United’s Lab Test Program

CEO SUMMARY: Providers seem to have a natural distrust of health insurers, particularly when payers introduce new programs with the stated purpose of improving quality and ensuring that physicians deliver evidence-based medicine. Doctors serving members of UHC’s HMO plans in Florida are…

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Theranos Pursues Different Business Plan in Arizona

CEO SUMMARY: Since its big public debut in late 2013, Theranos has been the subject of keen interest and much skepticism among pathologists and clinical laboratory professionals. Theranos is expanding its presence in Phoenix, Arizona. However, as it does, it looks more like a conventional…

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Doctors at Johns Hopkins Improve Lab Test Utilization

CEO SUMMARY: Efforts to help physicians improve their utilization of clinical lab tests paid big dividends at the Johns Hopkins Bayview Medical Center in Baltimore, Maryland. Working collaboratively, physicians and the clinical lab team identified overused or needless cardiac biomarker te…

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Humana Reduces Number of Labs in its Networks

CEO SUMMARY: In Ohio, a lab director said his lab was not informed directly about its exclusion from the Humana lab network. Lab officials got the word from their client physicians. In Texas, another lab director said Humana cut 35 lab contracts, reportedly because the insurer wanted to s…

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