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Payer Sues Pathologists For Clin Path Fee Refund

CEO SUMMARY: In September, Anthem filed three lawsuits against pathology groups in Virginia, seeking refunds and punitive damages of up to $1million from each pathology group for pathology professional services provided in hospital labs by these pathology groups during the period 2001 thr…

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Reactions To FL Court’s Ruling On Clin Path Fees

CEO SUMMARY: Reimbursement for clinical pathology professional services is under attack in a variety of ways throughout the United States. Recently a Florida Court of Appeal added a new court ruling to the growing body of legal decisions on this topic. Careful study of the ruling shows th…

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Institute of Medicine Calls For 12 Medicare Lab Reforms

CEO SUMMARY: Since 1987, the clinical lab industry has endured almost non-stop cuts in the absolute level of Medicare reimbursement for lab testing. But the time may be ripe for laboratories to work together to effect far-reaching reforms to Medicare laboratory payment policies. Just as t…

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Controversial Montana Ruling Pits Nurses Against Labs

MONTANA IS IN THE MIDST of an interesting feud over the scope of practice between nurses and certified laboratory professionals. On December 11, 2000, the Montana Board of Nursing issued a declaratory ruling stating that the scope of practice for nurses included performing unwaived …

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“December 4, 2000 Intelligence: Late Breaking Lab News”

Evidence continues to grow that consumers are using the Internet to actively intervene in their health care. The Pew Foundation released a report last week that says 52 million Americans are using the Internet “to gain knowledge about disease, investigate how to participate in clinic…

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Cheerios® Teaching Consumers Facts About Laboratory Testing

FOR YEARS, BOTH HOSPITAL LABS and independent commercial labs considered physicians and payers to be the primary customers for lab testing. The lab testing needs of patients as customers seldom came up when lab managers discussed how to organize and deliver their lab’s testing services. In fact, m…

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“July 31, 2000 Intelligence: Late Breaking Lab News”

Medical Management Programs, Inc. (MMP) of Southfield, Michigan is the new owner of the TPA (third party administrator) business formerly held by Universal Standard Medical Laboratories. MMP purchased the TPA business involving lab testing and home health services from USML’s Chapt…

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Legislators May Repeal NY Lab Surcharge Tax

CEO SUMMARY: After two years of concerted effort, laboratories in New York are optimistic that state legislators will finally repeal an 8.18% surcharge tax on clinical laboratory tests. The significant insight behind this story is how laboratories educated patients about the surcharge. Th…

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New York Laboratories Discover New Power

For those of you following the story of New York’s new surcharge on clinical laboratory tests, there is a great lesson to be learned. It is a lesson in the extensive power possessed by clinical laboratories. After New York’s hospital finance reform law passed the legislature last summer, lab ind…

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