TAG:
lab executive
Feds Nail Doctors for Accepting Bribes from Labs
HALLELUJAH! FOUR DOCTORS IN NEW JERSEY HAVE PLEADED GUILTY to federal criminal charges of accepting bribes from Biodiagnostic Laboratory Services (BLS), the clinical lab company in Parsippany, New Jersey. Can any of you remember the last time that a federal prosecutor pursued crimina…
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…
Why a Divided Lab Industry May Soon Fall
OVER THE PAST TWO DECADES, it has often been remarked on these pages and by many others that the divided nature of the laboratory medicine profession will prove to be its ultimate Achilles heel. These divisions center around different scientific disciplines within pathology and lab medicine as well a…
Labs Have New Hurdles as Some Payments Start
CEO SUMMARY: Some payments are beginning to flow for claims submitted under the new molecular test CPT codes. But there is a new issue. Medicare contractors, Medicaid programs, and private health insurers are deeming certain molecular tests to be medically unnecessary. Th…
Health Insurers See Big Increase in Lab Utilization
CEO SUMMARY: In a recent public workshop, managed care executives revealed that the annual cost of outpatient laboratory testing is increasing at twice the rate of all other medical services. One big driver in the increased spending on lab testing is increased utilization…
Unpaid for Molecular Tests, Some Labs Are Closing
THERE IS GREAT FRUSTRATION ACROSS THE LABORATORY MEDICINE PROFESSION on the subject of getting paid for claims covered by the new Tier I and Tier II molecular test CPT codes. We are now in the fifth month of the year and pathologists are still waiting for an acceptable resolution to this situation. …
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…
Payers Bolix MDx Codes, Labs Unpaid for Months
CEO SUMMARY: Clinical laboratories complain that implementation of a new payment system for molecular tests has been a disaster since January 1. Most contractors for the federal Centers for Medicare & Medicaid Services have not paid labs for molecular tests billed thi…
One Lab’s Revenue Loss Due to CMS’ Slow Process
CEO SUMMARY: How is it that some commercial payers for one lab running molecular tests have continued to pay the lab for tests it has run this year, but contractors for CMS have so far failed to pay? That’s the question one lab CEO is asking. Both the commercial payers and the CMS contr…
Lab Copays Announced by California Exchange
CEO SUMMARY: California will operate one of the nation’s largest health insurance benefit exchanges, as defined by the Affordable Care Act. Officials recently unveiled details about the exchange, to be called Covered California. Based on bronze, silver, gold, or platinum plan coverage, …
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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