TAG:
cpt
Health Insurers Now Finding Ways to Cut Costs and Shed Risks
CEO SUMMARY: Both employers and health insurers are taking aggressive steps to rein in healthcare costs. Several strategies to control spending and create powerful new incentives for providers are gaining favor. At this year’s Executive War College, Paul Mango of McKinsey & Company,…
2011’s Top 10 Lab Stories Point to a Busy 2012
CEO SUMMARY: Given the specific news stories that make up THE DARK REPORT’S list of the “Top Ten Lab Stories for 2011,” it might be said that 2011 was a rather quiet year overshadowed by anticipation of the coming reforms mandated by the Accountable Care Act of 2010. For the clinica…
ACLA Has its Say Regarding Molecular Dx Proposals
CEO SUMMARY: It is not known how many public comments have been submitted to Palmetto GBA, the big Medicare carrier, in response to its published proposals to change how code stacked claims for genetic and molecular tests will be handled, effective February 27, 2012, for labs in Medicare …
Molecular Code Stacks Now in the Payers’ Bull’s Eye
LIKE A STEAM BOILER READY TO EXPLODE FROM TOO MUCH PRESSURE, the nation’s health insurers have reached a point of no return on the subject of code-stacked claims for genetic testing and molecular diagnostics assays. Simply put, payers are ready to tackle this sensitive issue. Payers have reasonabl…
Palmetto GBA Announces Molecular Test Registry
CEO SUMMARY: Palmetto GBA, the nation’s largest Medicare Administrative Contractor (MAC), is asking labs in the J1 jurisdiction to submit applications for each molecular test they run. Molecular assays will receive a unique five-digit alpha-numeric identifier (Z-code) that will be enter…
Rite Aid Offers Free Tests to Preferred Customers
CEO SUMMARY: National pharmacy chain Rite Aid now offers free clinical laboratory tests to members of its customer-rewards program once they reach certain spending levels. After the customer’s specimen is tested, the laboratory test results are sent directly to the customer’s local Ri…
Medicare Carrier Plans to Reject Molecular Claims
CEO SUMMARY: In September, Palmetto, a Medicare carrier serving California and seven other states, made public two draft local coverage determinations (LCDs) that revamp its coverage guidelines for molecular diagnostic tests (MDT) and laboratory-developed tests (LDT). All labs su…
Office-Based Physicians Want In-Clinic Laboratories
CEO SUMMARY: Interest by office-based physicians in creating an in-clinic medical testing laboratory is on the increase. This has direct consequences for independent commercial labs, hospital lab outreach programs, and anatomic pathology groups, since office- based physicians are…
G-Men Mistakenly Raid Pathology Lab in Calif.
CEO SUMMARY: On February 10, 15 armed agents from the Department of Justice (DOJ) arrived at a pathology laboratory in Chico, California, to serve a search warrant and seize billing records, computers, and other evidence believed to be associated with fraudulent billing for CPT c…
More Reimbursement Threats for Lab Testing
WE ARE NOW WELL INTO THE FIRST MONTH OF 2011 and already there are plenty of signs that reimbursement for both clinical laboratory testing and anatomic pathology testing will come under siege from a variety of sources this year. Take, for example, the rather rapid action by the Centers for M…
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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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