TAG:
diagnostic laboratory tests
“I’m from the Government, and I’m here to help.”
By R. Lewis Dark | From the Volume XXVI No. 6 – April 29, 2019 Issue
Across the nation, clinical laboratories struggle to correctly interpret and follow the new National Correct Coding Initiative (NCCI) guidelines that took effect on Jan. 1. A financial disaster lies ahead for many labs. “The denials are very high right now and those denials are nationwide,” stat…
Attorney Explains 70/30 Rule, Pass-Through Bill Arrangements
By Joseph Burns | From the Volume XXV No. 10 – July 9, 2018 Issue
HOW THE LAB OUTREACH BUSINESSES of rural hospitals originate lab specimens and bill for lab tests is getting increased scrutiny. The reason for this rise in interest is that a growing number of rural hospitals are generating almost as much revenue from laboratory outreach testing as they get from all…
Legal Briefs Explain Problems with PAMA Implementation
By Joseph Burns | From the Volume XXV No. 6 – April 16, 2018 Issue
CEO SUMMARY: Several developments have moved the case forward since December when the American Clinical Laboratory Association filed suit in federal court against the Department of Health and Human Services. Inrecent weeks, ACLA filed for summary judgment; HHS responded with its own reque…
ACLA Sues HHS, Claims Flaws In How CMS Set 2018 Rates
By Joseph Burns | From the Volume XXV No. 4 – March 5, 2018 Issue
CEO SUMMARY: When the American Clinical Laboratory Association filed its lawsuit Dec. 11 against the Secretary of Health and Human Services, one of its main claims is that HHS collected payment data on the clinical laboratory testing business in a manner that was deeply flawed. HHS then u…
Some Labs Performing ADLTs May See Increased Medicare Fees
By Joseph Burns | From the Volume XXIV No. 15 – October 30, 2017 Issue
MIXED IN THE BAD NEWS concerning the proposed Clinical Laboratory Fee Schedule for 2018, there is some good news regarding what the federal Centers for Medicare and Medicaid Services proposes to pay for certain advanced diagnostic tests. After analyzing the proposed fee schedule, …
CMS Extends Reporting of Payer Prices by 60 Days
By Joseph Burns | From the Volume XXIV No. 5 – April 3, 2017 Issue
CEO SUMMARY: Last Thursday, the federal Centers for Medicare and Medicaid Services said it was extending the deadline for certain labs to report their private payer lab test prices by an additional 60 days, until May 30. Statements by CMS officials indicate that either or both the number …
Why Small Labs and Even Hospitals Are at Risk from PAMA Cuts
By Robert Michel | From the Volume XXIII No. 16 – November 28, 2016 Issue
CEO SUMMARY: Clinical lab executives and experts who have studied the final rule for PAMA lab test market price reporting are seriously concerned that the design of this rule may put many of the nation’s smallest, but still essential, clinical labs at great risk of financial distress, i…
Labs Have Heavy Burden to Report Lab Price Data
By Joseph Burns | From the Volume XXIII No. 15 – November 7, 2016 Issue
CEO SUMMARY: Clinical labs must assess their responsibilities to report lab test market prices to CMS as part of the Protecting Access to Medicare Act. A panel of three experts took up this topic at a recent webinar hosted by THE DARK REPORT. On June 23, the federal Centers for Medicaid &…
10% PAMA Fee Cut Would Lower Medicare Pay to Laboratories by $400 Million
By Joseph Burns | From the Volume XXIII No. 15 – November 7, 2016 Issue
CEO SUMMARY: Just eight weeks remain before certain clinical laboratories must begin submitting private payer lab test price data to the federal Centers for Medicare & Medicaid Services. A new report …
ADLT Final Rule Creates Tough Questions for Labs
By Joseph Burns | From the Volume XXIII No. 10 – July 25, 2016 Issue
IT’S GOING TO BE A DIFFERENT AND TOUGHER WORLD for laboratory companies that market proprietary molecular and genetic tests. That’s the opinion of experts who have studied the final rule governing Advanced Diagnostic Laboratory Tests (ADLTs) that the federal Centers for Medicare & Med…
CURRENT ISSUE
Volume XXXI, No. 14 – October 14, 2024
For the second time in the past 16 months, respected health systems have taken steps to collaborate specifically to advance value-based care. Also, several statewide pilot programs—each involving tens of thousands of newborns—are publishing studies that demonstrate how exome, whole genome sequencing, and rapid whole genome sequencing can deliver both improved patient outcomes and a return on investment.
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