TAG:

clinical lab

UnitedHealthCare’s New Policy Further Narrows Its Lab Network

UNITEDHEALTHCARE’S (UHC) RECENT MOVE to designate certain clinical and anatomic pathology laboratories as Designated Diagnostic Providers appears to be yet one more way that the insurer is narrowing its network. Effective July 1, 2021, and subject to st…

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Lab Professions ‘Haves,’ ‘Have Nots,’ and Thieves

ONCE AGAIN, THE LATEST NEWS OF IMPORTANCE in the clinical laboratory industry includes disparate topics that include legal/regulatory, new technology in anatomic pathology, fraud involving lab testing, and more consolidation in the in vitro diagnostics (IVD) industry….

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Restitution and Guilty Plea in Two Lab Fraud Cases

CEO SUMMARY: In one case, owners and a sales rep agreed to pay restitution totaling almost $10 million. In the second case, three defendants pled guilty to federal charges involving payment or receipt of kickbacks and illegal inducements. A fourth defendent in this second case, a ph…

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Despite COVID-19, Regular Lab Testing Expands

TIMES ARE GOOD FOR THE REGULAR RANGE of clinical laboratory and anatomic pathology testing services. Despite the COVID-19 pandemic, the daily number of routine test specimens is near pre-pandemic levels and certain sectors of lab testing—particularly genetic tests and some high-cost assays—are sh…

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Understanding Key Parts of New AKS, Stark Law Rules

CEO SUMMARY: Both the federal Stark Law and Anti-Kickback Statute have been revised and the final rules became effective on Jan. 19. The good news for clinical laboratories and anatomic pathology groups is that federal regulators from the Centers for Medicare and Medicaid Services a…

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COVID-19 Variant Sequencing Offers Clinical Opportunities

This is an excerpt of a 2,987-word article in the March 1, 2021 issue of  THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: In Wisconsin, an oncology research lab started sequencing variants of the SARS-CoV-2 virus and fou…

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SARS-CoV-2 Variant Sequencing Offers Clinical Opportunities

CEO SUMMARY: In Wisconsin, an oncology research lab started sequencing variants of the SARS-CoV-2 virus and found multiple uses for such test results to help hospitals, health systems, schools, and municipalities identify infection sources and track the virus’ spread. In one case,…

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Pathologist’s Prison Term Is a Warning for AP Groups

CEO SUMMARY: In January, a former VA pathologist was sentenced to 20 years in federal prison following his conviction on charges of involuntary manslaughter and mail fraud. The facts in this case show why leaders of clinical labs and pathology groups need to be aware of individuals …

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Hospitals Say New UHC Policy on Lab Network Is Anticompetitive

IT’S NOT OFTEN THAT HOSPITAL ASSOCIATIONS WILL DIRECTLY OPPOSE the changes that health insurers want to make in how they pay for clinical laboratory tests. But that is now happening with UnitedHealthcare’s new lab test payment policy that directly reduces what many hospital labs are paid fo…

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CAP Loses Accreditation Clients to Joint Commission

CEO SUMMARY: Over the past 18 months, several prominent national health systems decided to shift their CLIA laboratory accreditation services away from the College of American Pathologists and to The Joint Commission. These shifts from one accrediting body to another will involve hun…

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