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CMS Ready To Hack Away at Cost of Lab Testing

CEO SUMMARY: In July, the federal Centers for Medicare & Medicaid Services (CMS) published three proposed rules which would allow it to act independently of Congress to set prices for clinical laboratory testing and pathology services. Analyses of these proposed rules indicate that th…

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CMS Proposes Yet More Cuts for 2014, Beyond

CEO SUMMARY: In July, CMS proposed rules to cut payments under the Hospital Outpatient Prospective Payment System, the Physician Fee Schedule, and the Clinical Laboratory Fee Schedule. Under each program, the proposed payment cuts could have a significant and negative effect on the amount…

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Attorneys for CAP Say CMS Fee Proposals Illegal

CEO SUMMARY: In its comments about a proposal to change the way CMS pays for clinical laboratory and pathology services, the College of American Pathologists (CAP) said that CMS is using faulty assumptions. CAP further commented that the CMS proposal to cap physician fee schedule payments…

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CMS’ Proposed Lab Rules May Not Fly with Congress

CEO SUMMARY: Many clinical lab administrators have noticed the new activism at the federal Centers for Medicare Medicaid Services (CMS) when it comes to control of establishing prices for clinical laboratory tests. In this exclusive interview, two long-time advocates for the National Inde…

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Hospitals Recognize Need for Uniform Lab Test Data

CEO SUMMARY: Hospitals may soon insist that payers allow their in-house labs to provide outpatient testing regardless of exclusive managed care contracts with national lab companies. The migration to accountable care organizations (ACOs) and medical homes makes it essential that physician…

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PeaceHealth Lab Helps Docs with Info to Improve Outcomes

CEO SUMMARY: Described by its CEO as “an information company that happens to do laboratory testing,” PeaceHealth Laboratories of Springfield, Oregon, is moving swiftly to develop and deliver value-added services to its client physicians. The lab’s goal is to help re…

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House Bill Introduced to Address Rate-Setting for Molecular Tests

FEW PATHOLOGISTS OR CLINICAL laboratory directors would argue against revising the current Medicare payment policies for molecular and genetic tests. A bill proposed in Congress would do just that. The process now in use by Medicare Administrative Contractors (MACs) is inefficient and opaque, accord…

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July 29, 2013 “Intelligence: Late Breaking Lab News”

Another national health insurance corporation is preparing to institute pre-authorization for genetic tests. Cigna Corporation announced on July 23 that it had selected InformedDNA, to administer its new genetic testing and counseling program. Pathologists and laboratory administrators …

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BlueCard Policy Causing Clinical Labs to Go Unpaid

CEO SUMMARY: Clinical laboratories doing lab test work for Blue Cross Blue Shield patients using their BlueCard benefit are no longer being paid by the Blues plans. Some Blues plans are sending those reimbursement checks directly to their members with instructions for the patient to use t…

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July 08, 2013 “Intelligence: Late Breaking Lab News”

In China, independent clinical laboratories are in a fast-growth mode. That’s the conclusion of RnRMarketResearch in a newly-issued survey of the clinical laboratory testing market in China. It estimates this market segment at US$407 million annually. RnR says that three lab companies meet …

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