Tag: compliance requirements

Peeking at Whistleblower Claims: How Labs Induce Physicians

IN RECENT DECADES, probably no sector of the U.S. healthcare system has seen the level of fraud and abuse that seems to pervade the clinical laboratory industry. The common perception is that illegal inducements between lab companies and referring physicians are rampant and federal prosecutors have failed to bring enough violators to justice to effectively

View Article

Cigna Audits Tox Test Labs For Proof that Patients Paid

Cigna

CEO SUMMARY: In an unusually strong move, health insurer Cigna is auditing laboratories, including some labs that do toxicology testing. In these audits, the health insurer seeks documentation that the testing is medically necessary and that the laboratories are collecting copayments and deductibles from patients before Cigna pays the labs for the toxicology test claims. A lawyer working on these cases says that tactic may violate some state prompt-payment laws.

View Article

Theranos: Many Questions, but Very Few Answers

Theranos riddle image

CEO SUMMARY: Winston Churchill famously said that “Russia is a riddle wrapped in a mystery inside an enigma.” That description could apply to Theranos, the company that claims it is poised to disrupt the entire clinical laboratory testing industry. In Phoenix, where Theranos is ramping up its clinical lab marketing and operations, competing lab companies have it under the microscope. Some say not all may be going to plan and Theranos has been asked to comment on several issues.

View Article

Theranos: Many Questions, but Very Few Answers

Theranos riddle image

CEO SUMMARY: Winston Churchill famously said that “Russia is a riddle wrapped in a mystery inside an enigma.” That description could apply to Theranos, the company that claims it is poised to disrupt the entire clinical laboratory testing industry. In Phoenix, where Theranos is ramping up its clinical lab marketing and operations, competing lab companies have it under the microscope. Some say not all may be going to plan and Theranos has been asked to comment on several issues.

View Article

Aetna Files Suit against NJ Lab, Plans to Sue Two More Labs

FINALLY, A MAJOR HEALTH INSURER IS taking a hard line against clinical laboratories it suspects of committing fraud. Aetna Health, Inc., and Aetna Life Insurance Company, of Hartford, Connecticut, have sued one lab company and included physicians as defendants in that case. Aetna officials indicate that other lawsuits against labs can be expected.

At a minimum,

View Article

Pathologists Benefit from Hospital Lab Consulting

CEO SUMMARY: Deteriorating finances at many rural hospitals and smaller community hospitals is a growing trend. It is also a new consulting opportunity for local pathologists because financially-strapped hospitals often give their labs inadequate working capital and lack the staff needed to comply fully with state and federal compliance requirements. In Shreveport, Louisiana, Delta Pathology

View Article

How In-Clinic Path Lab Benefits GI Practice

CEO SUMMARY: In Manassas, Virginia, a five-physician gastroenterology group is using its in-clinic anatomic pathology laboratory to advance patient care, while boosting revenue associated with this ancillary service. In this exclusive interview, the group’s physician business leader shares the different ways that this in-house pathology service benefits both patients and physicians. Patients like the faster

View Article

Pathology Group Establishes Lab Test Exchange Networks

CEO SUMMARY: After several decades of steadfastly maintaining their independence from other pathology groups in their community, progressive hospital-based pathology groups are beginning to create regional laboratory testing networks. These collaborations generally start small and often involve just a few simple testing services. In North Carolina, one pathology group has created two separate test exchange

View Article