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New source of lab test abuse surfaces in the form of HOPDs and MSOs

This is an excerpt from a 2,350-word article in the Oct. 30, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. CEO SUMMARY: …

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Lab Scheme Recruits Hospitals To Bill as In-Network Providers

CEO SUMMARY: Management companies using a new generation of potentially fraudulent schemes are targeting hospitals and health systems for arrangements that use questionable means to increase lab test volume and revenue. The management companies often use the term “hospital outpatient de…

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XIFIN CEO White Analyzes Medicare 2018 Fee Cuts

CEO SUMMARY: If the draft lab rates that CMS published Sept. 22 for the Clinical Laboratory Fee Schedule for 2018 go into effect Jan. 1 as proposed, then clinical labs will see a cut of 28% in what they get paid for the top 20 most common tests, according to a recent analysis. The rates t…

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Proove Biosciences, Medicus Face Serious Fraud Charges

This is an excerpt from a 1,400-word article in the Sept. 18, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. …

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Go to a Football Game, Get a Free Genetic Test!

GENETIC TESTS REPLACED BOBBLEHEAD DOLLS AS THE GIVEAWAY at yesterday’s Baltimore Ravens home game against the Cleveland Browns. That’s a first in the world of professional sports! Tens of thousands of football fans received a fee DNA test kit as they entered the stadium on Sunday. The event was …

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Drug Testing Labs in Texas, California Deal With Fraud Charges

CEO SUMMARY: Two toxicology lab companies accused of fraud are fighting to stay in business. In the case of Medicus Laboratories of Dallas, it is asking a federal judge to issue a temporary restraining order to prevent state and federal lab regulators from pulling its CLIA license. At Pro…

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September 18, 2017 Intelligence: Late Breaking Lab News

Last week, 23andMe raised $250 million in a financing round led by Sequoia Capital. The company has an estimated value of $1.75 billion and has attracted $491 mill…

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Invitae Investing Heavily To Expand Market Share

CEO SUMMARY: In its first five years of offering clinical tests, Invitae has outspent revenue by $330.7 million. Yet its executives are confident that their company is on a path to becoming one of the dominant players in the genetic testing sector. This profile of Invitae will help pathol…

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Estimating Total Costs When Genetic Tests Must Be Retested

INVITAE, A GENETIC TESTING COMPANY IN San Francisco, has begun a retest program involving 50,000 patients. Such a large retest effort is without precedent in the still-nascent genetic testing marketplace. Clinical laboratories and genetic testing companies commonly find that, in dai…

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Two Largest Payers Start Lab Test Pre-Authorization

CEO SUMMARY: Once Anthem and UnitedHealthcare establish their respective genetic test prior-authorization programs, a new era for genetic testing will commence. The 80 million beneficiaries served by these two payers make up half of the individuals who have private health insurance. It is…

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