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PAMA’s New Rules Affect Lab Test Pricing, Coverage

CEO SUMMARY: For several reasons, the “Protecting Access to Medicare Act” (PAMA) has the potential to be the most disruptive federal legislation directed at the clinical lab industry since the enactment of CLIA 1988. Following passage of the law, some lab industry groups have taken di…

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Could Health Insurers Be at War with Clinical Labs?

CEO SUMMARY: It may sound ridiculous to assert that the nation’s largest health insurers are now “waging war” against clinical labs. However, some very smart people in the profession of laboratory medicine are expressing this opinion. To support such a conclusion, they point to paye…

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Speakers in New Orleans Offer Important Insights

CEO SUMMARY: In coming years, there will be multiple challenges and opportunities for the nation’s clinical laboratories and pathology groups. That was one common theme heard from the 90 speakers and panelists at the 19th annual Executive War College on Laboratory and Pathology Manageme…

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New Federal Law Changes How CMS Sets Lab Prices

CEO SUMMARY: CMS wanted more power to cut the prices it pays for clinical lab testing. A significant part of the lab industry wanted more transparency and consistency in how CMS established coverage guidelines and prices for new lab tests. Congress appears to have attempted to craft a law…

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New ISO 15189 Book Published to Help Clinical Lab Managers

THERE IS NOW A COMPREHENSIVE GUIDE for lab executives and lab managers interested in learning more about ISO 15189:2012, the latest version of the quality management system (QMS) for medical laboratories. It is a book titled: “A Practical Guide to ISO 15189 in Laboratory Medicine” and was publis…

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Eastern Canada’s Latest Lab Errors Get Attention

CEO SUMMARY: Authorities for Eastern Health in Newfoundland and Labrador province in Canada are conducting a root cause analysis after finding discrepancies in breast cancer testing that affected nine patients. Health officials said these cases were discovered as a result of an improved q…

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Labs, Path Groups Face Major Financial Issues

CEO SUMMARY: Are clinical labs and pathology groups ready for the end of fee-for-service reimbursement? That’s just one important question that will be answered at the upcoming Executive War College on Lab and Pathology Management that will take place in New Orleans on April 29-30. The …

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Physician Group ACO Targets High-Volume Tests for Savings

HERE’S AN EXAMPLE OF HOW an accountable care organization views cost control.  Atrius Health sought to control excess costs by focusing on high-priced items. It started with inappropriate hospitalizations and imaging studies and moved on to laboratory testing. Atrius Health is…

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Federal Judge Lets Trial Proceed in Case against Quest

CEO SUMMARY: Four California labs have charged that Quest Diagnostics engaged in predatory pricing in a case filed originally in November 2012. After the lawsuit was amended last summer and fall, U.S. District Judge William H. Orrick III heard various motions in the case. On February 6 he…

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Scrutinizing the Cost of Lab Testing

IT SEEMS LIKE THE COST OF LABORATORY TESTING continues to be a high-profile issue. On the pages that follow, you will read two different stories about how the cost of lab testing is undergoing intense scrutiny. This is not an accident. Rather, it shows how healthcare’s evolution is already undermin…

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