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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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Community Labs Arrive at a Crossroads

TODAY, COMMUNITY LABORATORIES ARE FACING THEIR TOUGHEST TIMES EVER. My definition of a community lab includes independent clinical lab companies, hospital lab outreach programs, and pathology groups serving community hospitals. Never before have community laboratories had to deal with so many discre…

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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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Federal Judge Rules Against Idaho Hospital in Antitrust Case

LAST MONTH, A FEDERAL JUDGE RULED that St. Luke’s Health System of Boise, Idaho, violated antitrust laws when, in 2012, it acquired Saltzer Medical Group, the largest independent medical practice in the state. In ruling against the merger of a hospital and physici…

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2013’s Top Ten Lab Stories Point to Tougher Times

CEO SUMMARY: For 2013, the big story was money—or, more accurately, less money for providers. This was not limited to clinical labs and pathology groups, but was equally true of hospitals and physicians. In THE DARK REPORT’S annual lookback at the year’s 10…

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Medicare Price Cuts Drive Labs to Sell or File BK

CEO SUMMARY: Professional investors are smart with their money. Thus, it is no surprise that clinical lab and pathology companies owned by private equity firms are the first to be sold or closed. These investors are acting in response to the cumulative negative financial impact of recent …

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Two Blood Brothers Report Declines in Revenue-Per-Req

REIMBURSEMENT FOR CLINICAL laboratory testing has declined, particularly for molecular tests. As a consequence, the nation’s two largest laboratory testing companies are feeling the negative effect of lower lab test prices. Both Quest Diagnostics Incorporated and Laborator…

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CMS Ready To Hack Away at Cost of Lab Testing

CEO SUMMARY: In July, the federal Centers for Medicare & Medicaid Services (CMS) published three proposed rules which would allow it to act independently of Congress to set prices for clinical laboratory testing and pathology services. Analyses of these proposed rules indicate that th…

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CMS’ Proposed Lab Rules May Not Fly with Congress

CEO SUMMARY: Many clinical lab administrators have noticed the new activism at the federal Centers for Medicare Medicaid Services (CMS) when it comes to control of establishing prices for clinical laboratory tests. In this exclusive interview, two long-time advocates for the National Inde…

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