Every pathologist and clinical lab administrator should pay attention to two federal court decisions made recently in two different legal cases. One decision is bad news for the entire clinical lab industry. The other is bad news for lab companies that push compliance with federal anti-kickback laws.
The most important court decision came in the American
WE ARE NOW IN THE NEW YEAR and the 2018 Medicare Clinical Laboratory Fee Schedule (CLFS) is a reality. The dramatic price cuts that the federal Centers for Medicare and Medicaid Services has enacted is the single most disruptive financial event the clinical laboratory industry has faced in the past two decades.
This is an excerpt from an 850-word article in the May 15, 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: There are few places and times where a broad cross-section of
CEO SUMMARY: Since Dec. 3, four unexpected megamergers became national news. Pharmacy chain CVS Health acquired Aetna. Advocate Health Care and Aurora Health Care will merge. UnitedHealth Group purchased the 2,000 physicians of DaVita Medical Group. Dignity Health and Catholic Health Initiates decided to create a super-hospital system with 139 hospitals in 28 states. Clinical
CEO SUMMARY: In September, Aetna filed a lawsuit in Pennsylvania accusing 14 defendants—including a hospital, a hospital management company, eight lab companies or lab management companies, two physicians, and two individuals—of defrauding Aetna, its client employers, and its members. The lawsuit is an example of a lab test arrangement in which independent lab companies and
This is an excerpt from a 2,400-word article in the Nov. 20, 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: Here at the dawn of the new era of value-based
CEO SUMMARY: With each passing year, the primary role of hospital and health system labs evolves in a different direction than that of independent lab companies. This trend is a response to the creation of integrated delivery networks paid on value and how they are scored on their ability to keep patients out of hospitals
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: Growing numbers of hospitals are being asked to enter into a
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 department (HOPD) billing model” to describe these arrangements. The scammers want the hospitals, as in-network
CEO SUMMARY: The urine drug testing industry is challenged every day to detect the large number of patients trying to cheat on their drug tests. GenoTox Laboratories of Austin, Texas, developed a DNA-authentication method for urine samples that allows the lab to detect when patients have used a substitute for urine when undergoing medication- and