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Public Comment Started on FDA LDT Regulations

CEO SUMMARY: On October 3, the FDA published draft guidelines to regulate laboratory-developed tests (LDTs). Pathologists and lab executives now have 120 days to comment on the guidelines. Several prominent national lab associations have expressed concerns about this additional bureaucrat…

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Cigna Sues HDL, Alleges Unlawful Fee Scheme

CEO SUMMARY: In court papers, Cigna alleged that HDL misrepresented patients’ responsibilities by promising not to collect co-payments, co-insurance, or deductibles. Also, HDL promised not to seek reimbursement from patients for any portion of its bills that the health insurer did not c…

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FL Docs Say: ‘No Thanks’ to UHC and BeaconLBS

CEO SUMMARY: Some Florida physicians are declaring their intent to leave UnitedHealthcare’s network because they find the insurer’s new BeaconLBS laboratory benefit management system to be time consuming and onerous. The defections come as the program goes through a soft launch that b…

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Humana Reduces Number of Labs in its Networks

CEO SUMMARY: In Ohio, a lab director said his lab was not informed directly about its exclusion from the Humana lab network. Lab officials got the word from their client physicians. In Texas, another lab director said Humana cut 35 lab contracts, reportedly because the insurer wanted to s…

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Theranos Pursues Different Business Plan in Arizona

CEO SUMMARY: Since its big public debut in late 2013, Theranos has been the subject of keen interest and much skepticism among pathologists and clinical laboratory professionals. Theranos is expanding its presence in Phoenix, Arizona. However, as it does, it looks more like a conventional…

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Protecting a Lab’s Access to Patients

TODAY I WANT TO CALL YOUR ATTENTION to a major issue in the lab testing industry that doesn’t get the full attention it deserves at most clinical labs and pathology groups. It is the fact that labs of all types and sizes are losing access to patients. Without access to adequate numbers of patients…

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Did Labs Rip Off Medicare? Feds Are Investigating

CEO SUMMARY: One reason why there is not a level playing field in lab industry compliance with laws governing kickbacks and anti-business behavior is that government officials do not act quickly against the lab industry’s worst offenders—if they take any action at all. News of a feder…

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Wall Street Journal Raises Allegations of Lab Fraud

CEO SUMMARY: Federal investigators are looking into possible violations of the antikickback law by a number of labs offering cardiology tests. The labs under investigation are alleged to have paid physicians processing fees of up to $20 per patient, the Journal reported in a front page st…

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Philly Blue Cross Contract: LabCorp In; Quest Out

CEO SUMMARY: Independence Blue Cross in Philadelphia decided to select Laboratory Corporation of America for its new eight-year managed care contract that took effect on July 1. However, the real story is the aggressive bidding war between the two national labs. Sources say LabCorp bid an…

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Longer Pay Cycle for Labs, Plus Lower Collection Rate

CEO SUMMARY: Across the United States, clinical labs, histology labs, and pathology groups are experiencing both a much longer payment cycle for claims and a decreased gross collection rate. Blame can be placed on several trends. One trend is the steady increase in the number of patients …

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