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January 27, 2020 Intelligence: Late-Breaking Lab News
In recent weeks, the Supreme Court declined to consider an appeal in a case which challenged a lab company’s patent on a clinical laboratory test. On Jan. 13, the justices rejected the appeal made by Athena Diagnostics, a division of Quest Diagnostics. In an earlie…
33 Groups Cooperated to Get PAMA-Related LAB Act Passed
>CEO SUMMARY: At the end of 2019, the Laboratory Access for Beneficiaries (LAB) Act became law and addressed two of the three most onerous requirements in the Protecting Access to Medicare Act (PAMA) of 2014. It delays the data-reporting requirements under PAMA, an…
Details Emerge in KU Hospital Misdiagnosis by Pathology Chair
AFTER A PATIENT FILED A LAWSUIT against a pathologist at the University of Kansas Hospital for fraud and negligence in a case stemming from a misdiagnosis of cancer in 2015, details about a settlement in the case were sealed. Now, some details have come out. Last month, NPR statio…
Anti-Trust Regulators Opposed Illumina, Pacific Bioscience Deal
IN TWO COUNTRIES, regulators concerned about a possible monopoly of technologies and instruments used in human gene sequencing apparently were a major reason why the $1.2 billion acquisition of Pacific Biosciences by Illumina Corporation will not happen. The two c…
How Northwell’s Lab Team Demonstrated Value Over 10 Years
CEO SUMMARY: Among hospital administrators, the popular wisdom is that their clinical lab is a cost center. This thinking leads them to consider drastic cost-management strategies that include partnering with commercial labs to manage in-hospital lab testing and the outright sale of lab o…
Labs May Be Excluded from Revised Stark Law, AKS Rules
This is an excerpt of a 1,460-word article in the Jan. 6, 2020 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: Here are early insights about a federal compliance reform that has not gotten much attention among clinical la…
In LabCorp Case, Judge Upholds Some Claim
CEO SUMMARY: In a federal lawsuit against Laboratory Corporation of America, plaintiffs who were uninsured or underinsured charged the lab company with engaging in “business practices that trick and harass customers into paying excessive prices.” Plaintiffs made this and other claims …
Lawsuits Allege LabCorp, Quest Overcharged Uninsured Patients
CEO SUMMARY: Court documents filed in U.S. District courts in New Jersey and North Carolina provide details about how each of the two lab companies set lab test prices differently—as much as 10 times higher—for cash-paying patients than for patients who have Medicare, Medicaid, or com…
ICD-10 Gives Payers More Data About Lab Claims
CEO SUMMARY: Evidence shows that adoption of ICD-10 diagnosis codes in 2015 made it possible for health insurers to track clinical laboratory testing more closely, ask more questions about those tests, and deny coverage. Increased detail about each patient’s condition has led to increas…
Prediction of ICD-10 as Negative for Labs Comes True
IMPLEMENTATION OF ICD-10 DIAGNOSIS CODES in the United States happened on Oct. 1, 2015. At that time, a national laboratory association predicted that use of ICD-10 codes would cause Medicare Administrative Contractors (MACs) to pay labs less often and with lower reimbursement. The Dark Report ag…
CURRENT ISSUE
Volume XXVII, Number 16 – November 16, 2020
UNWELCOME CHANGES to how labs do business are forcing labs to cope with high demand for COVID-19 testing while dealing with government and private payers interfering with normal operating procedures. Medicare has new requirements and payment rates for COVID-19 tests. Also reported here are UnitedHealthcare’s new Laboratory Test Registry Protocol, and California’s new COVID-19 testing laboratory that is diverting lab instruments, supplies, and test kits away from hospital and independent labs in the state.
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