TAG:
lab services
Insurers Sue To Challenge Pass-Through Bill Schemes
CEO SUMMARY: In two separate lawsuits filed in April, UnitedHealthcare (UHC) and Anthem each charged that drug testing companies used pass-through-billing schemes in ways the insurers say are fraudulent. UHC filed its lawsuit on April 18. One day later, on April 19, Blue Cross and Blue Sh…
Legal Briefs Explain Problems with PAMA Implementation
CEO SUMMARY: Several developments have moved the case forward since December when the American Clinical Laboratory Association filed suit in federal court against the Department of Health and Human Services. Inrecent weeks, ACLA filed for summary judgment; HHS responded with its own reque…
Insights from Jury Verdict in HDL, BlueWave Case
CEO SUMMARY: After a two-week trial, the executives of Health Diagnostic Laboratories and BlueWave Healthcare Consultants were found guilty of violating the federal False Claims Act. Defendants Tonya Mallory, Floyd Calhoun Dent III, and Robert Bradford Johnson were ordered to pay the Unit…
Alberta Health to Build New Lab to Serve Edmonton, Province
FOLLOWING YEARS OF CONTROVERSY associated with different plans to build a large new laboratory facility to serve Edmonton and the surrounding region, Alberta Health Services (AHS) will finance and build the new lab with its own resources. Last month, the Alberta government announced…
Lab Executives Declare Concerns about Fee Cuts
CEO SUMMARY: Members of Joint Venture Hospital Laboratories in Michigan anticipate that the 2018 Clinical Laboratory Fee Schedule rates being implemented under PAMA will lower payment from Medicare to less than the cost of running tests, especially for rural and critical access hospitals….
TOP 10 LAB STORIES OF 2017
1. CMS Sticks by Decision to Deeply Cut Medicare Part B Lab Test Fees SHORT OF A MIRACLE, the clinical laboratory industry is less than three weeks from the single most financially-disruptive event of the past 30 years. On Jan. 1, the federal Centers for Medicare and Medicaid Service…
Aetna Sues Hospitals over Alleged Lab-Billing Scheme
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….
Fla. Lab Sells to Labcorp, But Keeps Nursing Homes
CEO SUMMARY: Vista Clinical Diagnostics of Clermont, Fla., is betting big on the nursing home sector just when many labs serving nursing homes are worried about steep Medicare cuts coming Jan. 1. After selling its physician office referral testing, 35 patient service centers, and a mobile…
Lab Associations Comment on CMS Actions, Lab Fees
FOR THE LAB INDUSTRY, THE FEE CUTS proposed in the 2018 Clinical Laboratory Fee Schedule would be even more aggressive than what the federal Centers for Medicare and Medicaid Services had earlier predicted for Medicare Part B. In the days following the Sept. 22 publication of the pr…
AMA, AHA Join Labs to Request Delay, Fix
CEO SUMMARY: In what may be a first for the clinical lab industry, the American Medical Association and the American Hospital Association joined with 20 other healthcare associations to ask CMS Administrator Seema Verma to address the problems with the CMS proposal involving Medicare Part B f…
CURRENT ISSUE
Volume XXXI, No. 5 – April 8, 2024
The fragmentation of consumer markets is reflected in clinical lab services, and The Dark Report examines this trend and how it will impact labs in the coming years. Also, The Dark Report notes that the FDA has issued a controversial memo to reclassify many high-risk IVD assays.
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