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Florida Pathology Group Lost Volume After BeaconLBS Started

CEO SUMMARY: A 22-physician pathology group in Tampa has complied with rules for lab test ordering that UnitedHealthcare and BeaconLBS established, yet has experienced a steep decline in the volume of specimens it receives. Physicians told the pathologists that other labs were not using t…

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PAMA Final Rule a Threat To Community Lab Survival

CEO SUMMARY: Will implementation of the final PAMA private payment rate reporting rule for labs put smaller, community labs at financial risk? Yes, says the National Independent Laboratory Association (NILA). By deliberately setting a standard to exclude private payer payment data from ho…

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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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June 13, 2016 Intelligence: Late Breaking Lab News

Life insurers are adopting healthcare big data as part of their underwriting process and clinical laboratory test data has an important role. Quest Diagnostics Incorporated participates in this business line. Huffington Post recently published a story on this topic and ident…

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Payers Asking for Repayment When Labs Waive Fees

CEO SUMMARY: Health insurers appear to have stepped up their efforts to warn clinical laboratories not to waive patients’ fees in return for specimen referrals. Consultants also say that payers are increasing enforcement efforts. There are cases where, when insurers discover labs have n…

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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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Henry Ford Health System Laboratory Division Combines Lean with ISO 15189

CEO SUMMARY: As healthcare transitions away from fee-for-service payment and adopts new models of reimbursement, every clinical lab will need to deliver more value with its lab testing services. At Henry Ford Health System in Detroit, the laboratory division has blazed a path of improving…

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Payers Using Two Approaches To Price Molecular, Genetic Tests

PRIVATE PAYERS AND MEDICARE contractors are taking divergent approaches to establishing coverage policies and setting prices for molecular and genetic tests. That’s what Kuo Bianchini Tong, MS, CEO of Quorum Consulting Inc., sees happening. “One approach seeks to recognize the c…

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NY Times Asks: ‘Is Lab Testing the Wild West?’

HOW MANY OF YOU SAW THE NEWS STORY PUBLISHED LAST MONTH by The Wall Street Journal with the headline, “Is Lab Testing the ‘Wild West’ of Medicine?” It is the latest in a series of news stories about issues and questions involving the accuracy and quality of clinical laboratory tests …

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Lab Stakeholders Take Action to Prevent Drastic Cuts in the Medicare Lab Fee Schedule

WITH MANY CLINICAL LABORATORY STAKEHOLDERS anticipating major revenue shortfalls due to the Protecting Access to Medicare Act lab test mar…

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