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Two Blood Brothers Report Declines in Revenue-Per-Req
REIMBURSEMENT FOR CLINICAL laboratory testing has declined, particularly for molecular tests. As a consequence, the nation’s two largest laboratory testing companies are feeling the negative effect of lower lab test prices. Both Quest Diagnostics Incorporated and Laborator…
CMS’ Proposed Lab Rules May Not Fly with Congress
CEO SUMMARY: Many clinical lab administrators have noticed the new activism at the federal Centers for Medicare Medicaid Services (CMS) when it comes to control of establishing prices for clinical laboratory tests. In this exclusive interview, two long-time advocates for the National Inde…
Attorneys for CAP Say CMS Fee Proposals Illegal
CEO SUMMARY: In its comments about a proposal to change the way CMS pays for clinical laboratory and pathology services, the College of American Pathologists (CAP) said that CMS is using faulty assumptions. CAP further commented that the CMS proposal to cap physician fee schedule payments…
CMS Ready To Hack Away at Cost of Lab Testing
CEO SUMMARY: In July, the federal Centers for Medicare & Medicaid Services (CMS) published three proposed rules which would allow it to act independently of Congress to set prices for clinical laboratory testing and pathology services. Analyses of these proposed rules indicate that th…
Medicare’s Latest Attack on Lab Test Prices
MANY OF YOU KNOW ABOUT THE PROPOSED NEW MEDICARE RULE by the Centers for Medicare & Medicaid Services (CMS) that it would use to initiate a review of the prices it pays for 1,250 clinical laboratory tests under the Medicare Part B Clinical Laboratory Fee Schedule (CLFS). However…
BlueCard Policy Causing Clinical Labs to Go Unpaid
CEO SUMMARY: Clinical laboratories doing lab test work for Blue Cross Blue Shield patients using their BlueCard benefit are no longer being paid by the Blues plans. Some Blues plans are sending those reimbursement checks directly to their members with instructions for the patient to use t…
Big Lab Industry Stories Reveal Trouble Ahead
CEO SUMMARY: One after another, a series of breaking news stories points to more rough waters ahead for the entire clinical lab industry. Of greatest interest is the ongoing questions about when clinical labs and pathology groups will get paid for the molecular test claims they have submi…
Why One Molecular Diagnostics Company Closed Its Doors
CEO SUMMARY: When executives closed the doors of Pathwork Diagnostics last month, the simple explanation was that reimbursement for its proprietary molecular diagnostic test was inadequate. Indeed, that was part of the story. But other factors played significant roles in impeding…
Labs Should Prepare for Larger Patient Deductibles
CEO SUMMARY: Employers are taking active steps to control the year-over-year increases in the cost of health benefits. One strategy gaining favor is to move employees away from traditional health plans and enroll them in high-deductible health plans (HDHPs). This is a trend with huge fina…
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….
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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