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Is New Cycle of Fraud Plaguing Lab Industry?

CEO SUMMARY: Taken collectively, the growing number of federal investigations of clinical lab companies and health insurer lawsuits against lab companies alleging fraudulent business practices signals a disturbing new trend for the lab industry. Although these allegations are lev…

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Cigna Audits Tox Test Labs For Proof that Patients Paid

CEO SUMMARY: In an unusually strong move, health insurer Cigna is auditing laboratories, including some labs that do toxicology testing. In these audits, the health insurer seeks documentation that the testing is medically necessary and that the laboratories are collecting copaym…

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Collecting Big Patient Deductibles

THERE HAS BEEN EXPLOSIVE GROWTH IN THE NUMBER OF PATIENTS enrolled in high-deductible health plans. Currently, more than 20 million people have HDHPs. This is one reason why many labs are experiencing high levels of patient bad debt never before seen by the lab industry during the past three decades….

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How Price Transparency Increased Lab’s Revenue

CEO SUMMARY: In California, a gene testing firm is increasing satisfaction among patients and physicians with a tool that provides patients with an estimate of the anticipated cost—before the physician orders a test! By providing transparency about the cost of tests upfront, Co…

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New Company Ready to Heat Up Slow Digital Pathology Market

CEO SUMMARY: There’s a new competitor in the digital pathology marketplace with ambitious plans to deliver a fully-integrated pathologist workflow solution. Inspirata, Inc., of Tampa, Florida, made its debut in March at an international pathology conference. In this exclusive i…

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Investment Bank Bullish On Clinical Labs, Pathology

CEO SUMMARY: For clinical laboratories and anatomic pathology groups willing to adapt to the evolving needs of the American healthcare system, there are many positive opportunities. That’s the view of a Wall Street investment bank that just published a report on the lab testing…

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Newer, Smaller Analyzers Will Bring Big Data to Labs

CEO SUMMARY: Clinical laboratories of all sizes are poised to become the source of much of a hospital or health system’s “big data.” At many academic center labs, greater use of genetic and molecular testing requires that more space and more staff be devoted to data management. A…

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Deep-Discount Lab Prices to Haunt All California Labs

FOR MORE THAN 20 YEARS, THE CLINICAL LAB INDUSTRY been marked by a fundamental schism. On one side of the schism are the public lab companies that have aggressively used deeply-discounted loss-leader pricing practices when negotiating managed care contracts to capture market share. On the other si…

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Opko Pays $1.47 Billion to Buy Bio-Reference Lab

CEO SUMMARY: It’s a case of the little fish gobbling the big fish, as Opko Health – with revenue of $91 million – will be acquiring Bio-Reference Laboratories, with revenue of $832 million. But the more interesting aspect of the story is that the CEO of Opko Health is a physi…

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Medi-Cal to Cut Lab Pay on July 1 by 25% to 30%

CEO SUMMARY: Since 2011, state officials in California have aggressively cut laboratory testing fees for Medi-Cal, the state’s Medicaid program. Now state officials say they will implement a new methodology next month for determining lab testing fees. The new methodology is based…

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