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Feds Show How Labs Took $500 Million from Medicare

CEO SUMMARY: In this second phase of the whistleblower case against three cardiology testing labs and a sales consulting company, federal prosecutors are requesting a jury trial against the individuals named in the court documents filed August 7. Federal investigators alleged t…

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Is New Cycle of Fraud Plaguing Lab Industry?

CEO SUMMARY: Taken collectively, the growing number of federal investigations of clinical lab companies and health insurer lawsuits against lab companies alleging fraudulent business practices signals a disturbing new trend for the lab industry. Although these allegations are lev…

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Detroit Hospital Develops 10 Ways To Add More Value

CEO SUMMARY: Clinical labs are beginning to make the transition from a volume-based financial model to a model based on value-based payments. To survive this transition, labs must find ways to create value. The lab at Henry Ford Health System has  identified 10 ways that it c…

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Collecting Big Patient Deductibles

THERE HAS BEEN EXPLOSIVE GROWTH IN THE NUMBER OF PATIENTS enrolled in high-deductible health plans. Currently, more than 20 million people have HDHPs. This is one reason why many labs are experiencing high levels of patient bad debt never before seen by the lab industry during the past three decades….

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How Price Transparency Increased Lab’s Revenue

CEO SUMMARY: In California, a gene testing firm is increasing satisfaction among patients and physicians with a tool that provides patients with an estimate of the anticipated cost—before the physician orders a test! By providing transparency about the cost of tests upfront, Co…

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Newer, Smaller Analyzers Will Bring Big Data to Labs

CEO SUMMARY: Clinical laboratories of all sizes are poised to become the source of much of a hospital or health system’s “big data.” At many academic center labs, greater use of genetic and molecular testing requires that more space and more staff be devoted to data management. A…

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Hit by Many New Genetic Tests, Health Insurers Just Say ‘No’

OVERWHELMED WITH REQUESTS TO PAY for new genetic tests, health insurers, particularly smaller and regional insurers, find it easier to simply deny payment for such tests. This is one of the insights shared during a panel discussion involving several managed care executives at the 20th annual Exe…

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Medicare Ends Coverage for Genetic Drug-Sensitivity Tests

CEO SUMMARY: Medicare’s decision to cease covering many pharmacogenomic tests puts as many as 19 million Americans who have genetic variations affecting their response to medications at risk. These medications are commonly prescribed for patients with cardiovascular disease, pain…

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June 22, 2015 Intelligence: Late Breaking Lab News

Turf wars are breaking out among local pathology groups as consolidation involving hospitals and physicians’ practices continues to reshape many regional healthcare markets. The latest sign of this trend comes from Washington State, where CellNetix of Seattle announced an agreement to provide …

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Some Labs Report Faster Pay for Molecular, Genetic Tests

DURING RECENT MONTHS, some labs are reporting improvement in how their claims for certain molecular and genetic tests are being reimbursed. This is progress from the financial crises experienced during 2013 for many labs performing molecular and genetic tests….

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