TAG:
cpt code
Top 10 2014 Biggest News Stories
Story no.1 SGR Fix by Congress Spawns PAMA; Lab Industry Wary of Law’s Impact ON APRIL 1, PRESIDENT BARACK OBAMA signed into law the Protecting Access to Medicare Act of 2014 (PAMA). As written, it has the potential to be the most impactful federal legislation on the clinical lab industry s…
More Genetic Counseling Leads to Fewer Lab Tests
CEO SUMMARY: Cigna was the first national health insurer to require independent board-certified genetic counseling before approving coverage for certain genetic tests. Since launching this program in September 2013, the insurer has seen a 450% increase in genetic counseling for Cigna …
Could Health Insurers Be at War with Clinical Labs?
CEO SUMMARY: It may sound ridiculous to assert that the nation’s largest health insurers are now “waging war” against clinical labs. However, some very smart people in the profession of laboratory medicine are expressing this opinion. To support such a conclusion, they point to paye…
Speakers in New Orleans Offer Important Insights
CEO SUMMARY: In coming years, there will be multiple challenges and opportunities for the nation’s clinical laboratories and pathology groups. That was one common theme heard from the 90 speakers and panelists at the 19th annual Executive War College on Laboratory and Pathology Manageme…
Pathologists Face Unsettling Times
THESE ARE UNSETTLING TIMES FOR PATHOLOGISTS, particularly those who practice in a private pathology group that serves one or more community hospitals. Blame it on healthcare’s unfolding transformation and the new aggressiveness of payers to cut the prices they pay for anatomic pathology services. …
Congress’ New SGR Law Has Mixed News for Labs
CEO SUMMARY: Once again, the lab industry faces a mixed bag following passage of a new law by Congress last week. Besides the one-year fix for the SGR, H.R. 4302 also has language that may defer adjustments to Medicare Part B lab test fees until 2017 and creates a new procedure for Medica…
Anatomic Pathology Business Faces Uncertain Future
CEO SUMMARY: There’s a day of reckoning on the way for the traditional business model of the private pathology group practice. At most risk are smaller pathology groups that typically have five or fewer pathologists. Blame it on the reduced prices that Medicare and private insurers are …
Tricare, DOD Not Paying for MoPath Codes, LDTs
CEO SUMMARY: It turns out that labs serving Tricare patients are going unpaid for certain LDTs, molecular, and genetic tests. The issue of nonpayment began in January 2013 when Tricare stopped paying for these tests that were billed under the new molecular CPT codes that replaced the prev…
CMS Cuts BRCA Price by 49% in Response to Competition
IN THE FINAL WEEKS OF 2013, the federal Centers for Medicare & Medicaid Services (CMS) announced that it would reduce the price it pays for the BRCA genetic test by 49%, to $1,438, effective on January 1, 2014. For Myriad Genetics, Inc., this wa…
2013’s Top Ten Lab Stories Point to Tougher Times
CEO SUMMARY: For 2013, the big story was money—or, more accurately, less money for providers. This was not limited to clinical labs and pathology groups, but was equally true of hospitals and physicians. In THE DARK REPORT’S annual lookback at the year’s 10…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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