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Payers Asking for Repayment When Labs Waive Fees
CEO SUMMARY: Health insurers appear to have stepped up their efforts to warn clinical laboratories not to waive patients’ fees in return for specimen referrals. Consultants also say that payers are increasing enforcement efforts. There are cases where, when insurers discover labs have n…
UnitedHealth Sues 5 Tox Labs, Says It Was Defrauded of $50M
FLORIDA IS ONCE AGAIN GROUND ZERO for a major case of lab testing fraud. UnitedHealthcare has filed suit against five toxicology laboratory companies, three general partners in those companies, eight urinalysis referral sources, and other entities, claiming the defendants defrauded t…
Gene Testing Lab Goes ‘Cold Turkey,’ Stops Billing Health Plans
CEO SUMMARY: Last year, Kailos Genetics stopped collecting third-party payment, dropped its prices sharply, and started marketing its genetic-screening tests directly to consumers and physicians. At the time, 100% of its revenue came from third-party payers. Today, it gets 100% of its rev…
At Executive War College 2016, Two Big Lab Market Trends
CEO SUMMARY: What happens when 100 lab experts interact with an audience of more than 850 lab administrators, pathologists, and IVD executives from across the United States and seven other nations? A consensus of sorts emerges and during this 2016 edition of the Executive War College on L…
200-Analyte Medication Test Panel Adds Value for Physicians
CEO SUMMARY: Delivering more value with lab tests requires going beyond simply working with physicians to improve test utilization by focusing on unnecessary or inappropriate tests. PeaceHealth Laboratories in Oregon successfully executed a two-step strategy to add value with its testing …
CMS Update Plans for Medicare Clinical Lab Fee Schedule Could Be in Trouble
This is an excerpt from a 1,400-word article in the April 11 issue of THE DARK REPORT. Full details of the California program are included in the original article, available to paid members. CEO SUMMARY: Evidence from California shows that national la…
Giving Back to the Clinical Lab Profession
MANY OF US ARE CONCERNED about how the next generation of clinical lab and anatomic pathology leaders will be trained and prepared to step up and assume responsibility for the clinical excellence and financial performance of their respective lab organizations. To contribute to the training of prom…
How to Cover Genetic Tests Confounds Health Insurers
CEO SUMMARY: Managed care experts say health insurers are being overwhelmed by the number of new genetic tests and that many labs find it tough to get paid for these tests. UnitedHealthcare just announced it will require pre-authorization of molecular and genetic tests during 2016. Me…
Marshfield Clinic Lab Tackles Phlebotomy Workflow Redesign
CEO SUMMARY: Before a redesign of phlebotomy workflow at Marshfield Clinic, patients might wait as long as an hour, particularly before noon when phlebotomists would see 75% of each day’s patients. After the redesign, the number of draw sites was reduced from five to two while hand…
Accumen Acquires Chi To Beef Up Lab Consulting
CEO SUMMARY: Two different business models of clinical laboratory consulting have now been brought together. Chi consultants have long focused on analytics and improving outreach performance, among other areas of lab performance. By contrast, Accumen’s business model is nontradition…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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