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ACLA, CAP Comment on Final 2014 Medicare Rules

CEO SUMMARY: On November 27, as the nation prepared for the Thanksgiving holiday, the federal Centers for Medicare & Medicaid Services (CMS) announced the long-awaited final rules for 2014. Early analysis of the 1,300 pages of rules CMS released indicates that the agency moderated one…

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Medicare Overstepped With Proposed Rules

FOR SEVERAL YEARS NOW, officials at the federal Centers for Medicare & Medicaid Services (CMS) have signaled their unhappiness with the status quo in how coverage guidelines and prices must be established for clinical laboratory testing and anatomic pathology services. These pag…

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Walgreens To Go National with Lab Tests in Stores

CEO SUMMARY: A disruptive innovation is one that shakes up an entire market or industry. By adding clinical lab testing to its health services offerings in more than 8,100 stores nationwide, Walgreens could disrupt the status quo in the clinical lab industry. Walgreens says its lab partne…

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Theranos Won’t Discuss Disruptive Lab Technology

CEO SUMMARY: In a partnership with Walgreens pharmacies, Theranos Inc. announced that it will run clinical lab tests on “micro-samples” and collect these blood samples without venipuncture. Even as Theranos touts the patient-friendly benefits of its proprietary diagnostic technology, …

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Medicare’s Latest Attack on Lab Test Prices

MANY OF YOU KNOW ABOUT THE PROPOSED NEW MEDICARE RULE by the Centers for Medicare & Medicaid Services (CMS) that it would use to initiate a review of the prices it pays for 1,250 clinical laboratory tests under the Medicare Part B Clinical Laboratory Fee Schedule (CLFS). However…

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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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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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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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