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Hospital and LabCorp Hit with $50 Million Verdict

LAWYERS CALL IT A ‘WRONGFUL BIRTH.’ When no one spots an error in prenatal genetic testing processes, a wrongful birth can result, and that’s what happened in a case that ended last month with a jury award of $50 million to a family in Burien, Washington. Defendants Valley Medical Cent…

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Claritas Is Example of New Lab Business Model

CEO SUMMARY: One by one, new business models for clinical laboratory testing are popping up. Each is a response to healthcare’s rapid evolution, the ongoing decline in lab test reimbursement, and the growing role for molecular diagnostics and genetic testing. In Cambridge, Massachusetts…

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Reporters & Investigators Target Fraud in Pain Management Market

PAIN MANAGEMENT IS COMING under increased scrutiny by law enforcement officials and government regulators. Even the national media have begun to notice the fraud and abuse that is rampant in this rapidly-expanding sector of healthcare. Many pathologists and clinical laboratory managers will welcome …

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Laboratory Offers Early Lessons in Positioning for Success with ACOs

CEO SUMMARY: Accountable care organizations (ACOs) are already leading the shift from fee-for-service reimbursement to population payment. ACOs are leading healthcare’s evolution to preventive care, wellness, and better management of patients with chronic disease. This evolution will re…

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July 29, 2013 “Intelligence: Late Breaking Lab News”

Another national health insurance corporation is preparing to institute pre-authorization for genetic tests. Cigna Corporation announced on July 23 that it had selected InformedDNA, to administer its new genetic testing and counseling program. Pathologists and laboratory administrators …

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Labs Face Consequences from MolDx Test ‘Mess’

CEO SUMMARY: Non-payment of molecular test claims for the first five months of 2013 is not the only financial disruption for labs that perform these tests. Reports are coming in about how Medicare contractors, Medicaid programs, and private payers are declining to pay claims based on ruli…

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Health Insurers See Big Increase in Lab Utilization

CEO SUMMARY: In a recent public workshop, managed care executives revealed that the annual cost of outpatient laboratory testing is increasing at twice the rate of all other medical services. One big driver in the increased spending on lab testing is increased utilization…

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Dartmouth Builds New Lab to Serve Growth in Testing

CEO SUMMARY: Demand for specialized reference and esoteric testing is so robust at Dartmouth Hitchcock Medical Center in New Hampshire that the academic center is building an expanded laboratory facility to accommodate the increased volume of tests it handles each year. A favorable trend …

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Executive War College Sessions Center Upon Three Trends

CEO SUMMARY: There was an interesting blend of anxiety and optimism as a record crowd gathered in New Orleans last week for the 18th annual Executive War College on Laboratory and Pathology Management. The anxiety was rooted in the shrinking prices paid by payers for lab testing services….

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How CMS ‘Mismanaged’ Pricing of Molecular Tests

CEO SUMMARY: CMS and its contractors had ample opportunity to implement a new reimbursement system but failed to act in a timely manner, stated an expert familiar with the problem. The result is that laboratories, particularly those that have one or two proprietary molecular tests, are be…

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