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UnitedHealthcare to Bring BeaconLBS to Texas

CEO SUMMARY: With a quiet announcement this month that it was bringing its laboratory benefit management program to Texas on March 1, 2017, UnitedHealthcare is taking on a big challenge. Enrollment in UHC’s commercial plans in Texas is 4.3 million. That is twice the two million commerci…

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Can Clinical Laboratories Adjust To ‘New’ Healthcare System?

CEO SUMMARY: Month by month, there is increased clarity in the path the American healthcare system will follow as hospitals, health systems, and physicians integrate clinical care, manage populations, and practice personalized and precision medicine. While these changes play out, clinical…

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Attorney Jane Pine Wood to Be Chief Legal Counsel at Bio-Reference

One of the most widely-respected and trusted attorneys serving the clinical laboratory industry and anatomic pathology profession is leaving private practice to join the corporate world. …

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Labs Caught Between Employer Hammer, Payer Anvil

STARTING ON JANUARY 1, 2017, THE CLINICAL LABORATORY INDUSTRY will undergo a new experiment in price-setting (and price-cutting) by the federal Centers for Medicare & Medicaid Services. On that date, certain labs must begin reporting market price data for each test and each payer…

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Alert to All Labs: Beware Of ‘Reference Pricing’

CEO SUMMARY: “Reference pricing” does not refer to how a lab negotiates prices with its reference lab! Rather, reference pricing describes a specific approach to health plan benefits that incentivizes the consumer to choose lower-cost providers while allowing that consumer to still us…

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What will the future hold for Theranos?

This is an excerpt from a 1,900-word article in the July 25 issue of THE DARK REPORT. The complete article is available to paid members of the Dark Intelligence Group. …

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Theranos Now Scrambling To Save What It Can

CEO SUMMARY: On July 7, CMS imposed severe sanctions on Theranos for CLIA violations. Included is a two-year ban on owning and operating a clinical laboratory for Theranos, CEO Elizabeth Holmes, the former COO, and the former medical director. Theranos appears to be pivoting away from a c…

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PAMA Final Rule Issued, CMS Plans to Cut Rates by 5.6%

CEO SUMMARY: CMS issued its final rule for implementing the laboratory payment reform included in the Protecting Access to Medicare Act of 2014 (PAMA) on June 17. All labs will see significant reductions to the Medicare Part B Clinical Laboratory Fee Schedule that becomes effective on Jan…

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Is Theranos Kowtowing To CMS over Pending CLIA Sanctions?

CEO SUMMARY: Having ignored the profession of laboratory medicine for nearly all of its 13-year corporate life, Theranos suddenly began engaging with expert laboratorians last month. The timing of this new outreach coincides with public disclosure that CMS proposed the severest sanctions …

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Theranos Saga Just Keeps Getting More Intriguing

This is an excerpt from a 400-word article in the May 2 issue of THE DARK REPORT. The complete article is available paid members of the Dark Intelligence Group. …

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