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Report Shows Price Drop for Most Molecular Tests

CEO SUMMARY: In recent weeks, labs are reporting that Medicare contractors have begun to issue payments for molecular test claims filed—but unpaid—since January 1, 2013. A newly-issued analysis of this situation by Quorum Consulting indicates that, for many molecular assays, Medicare …

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Aetna Threatens to Expel Docs for Out-of-Network Lab Referrals

MANAGED CARE PLANS are taking aggressive steps to keep clinical lab testing within their preferred networks. In particular, Aetna, Inc., is earning a reputation as one of the toughest insurers in this regard. Most recently, in a letter sent to at least one network physician, Aetna w…

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Why a Divided Lab Industry May Soon Fall

OVER THE PAST TWO DECADES, it has often been remarked on these pages and by many others that the divided nature of the laboratory medicine profession will prove to be its ultimate Achilles heel. These divisions center around different scientific disciplines within pathology and lab medicine as well a…

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OIG Tells CMS It Could Save $910 Million on Lab Test Costs

IT IS ONE MORE POWERFUL SIGN of the changing times. Last week, the Office of the Inspector (OIG) publicly released a study it had done of the prices paid for lab testing and how the Medicare program could use this information to reduce the cost of Part B clinical laboratory testing. It was The W…

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Reimbursement System Fails Labs and Patients

There is confusion and disruption in the molecular testing sector of the clinical lab testing industry. That’s because both government and private payers were not ready to process and reimburse for the 100+ new molecular CPT test codes on January 1, 2013. That is the date when the Medicare program…

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Anticipating Washington’s Next Blows to Lab Testing

CEO SUMMARY: With the advent of 2013, almost every lab was responding to some type of price cut. Clinical labs are dealing with the sequential, multi-year cuts to the Medicare Part B Lab Test Price Schedule. Anatomic pathology labs are still adjusting to the expiration of the TC Grandfath…

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Anticipating 2013 Trends in Clinical Lab and Pathology

CEO SUMMARY: Biggest news for 2013 will the impact of significant price cuts for both clinical lab and anatomic pathology testing services. But the bad news doesn’t stop there. Employers and private payers will be more aggressive in taking steps to reduce what they spend on lab testing….

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Ascend Clinical Acquires PathCentral Lab Business

CEO SUMMARY: Ascend Clinical and PathCentral see an opportunity to provide sophisticated services to community pathology groups. Ascend Clinical will expand the molecular diagnostic and gene sequencing business it is purchasing from PathCentral. PathCentral will concentrate on marketing i…

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Preserving Competition Is Goal of California Lawsuit

CEO SUMMARY: Once again, the use of deeply-discounted lab test pricing to win exclusive managed care contracts is involved in a court case. However, this latest private lawsuit is different from earlier cases because it seeks to preserve competition in the lab testing and the managed care…

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RDX Alters Business Plan Due to Lab Market Changes

CEO SUMMARY: Executives at Regional Diagnostic Laboratories (RDX) made a splash last May when they announced the new company’s plans to acquire hospital laboratory outreach programs, backed by a capital commitment of $250 million. Now, in recognition of swift changes in the lab test mar…

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