TAG:
lab test prices
Discounted Lab Prices Become Issue in California
CEO SUMMARY: For decades, California’s lab testing market has been considered the Wild West because clinical lab companies have felt relatively free to offer deeply-discounted prices to expand market share and take business away from competitors. Now these discounted pricing pr…
Medi-Cal Gets Tough on Low Lab Test Prices
CEO SUMMARY: This may be the most significant lab industry story of 2010, which has gone unreported until now. Starting in June and July, California’s Department of Health Care Services determined that between 10 and 30 labs had submitted what the agency considers to be false c…
Who Wins and Who Loses With 51501 Enforcement
CEO SUMMARY: Assume that California’s Department of Health Care Services (DHCS) wins all challenges to enforcement of its interpretation of 51501(a). DHCS will get a one-time cash infusion as it collects money from labs which violated the state statute. But going forward, feder…
Did Qui Tam Suit Trigger Medi-Cal Price Concerns?
CEO SUMMARY: It is easy to track backwards to understand why the California Department of Healthcare Services (DHCS) began aggressive enforcement of its interpretation of statute 51501(a) against a number of labs this summer. DHCS officials were given a full education and a roadm…
Aetna Sues LabCorp Over Lab Marketing Practices
CEO SUMMARY: Aetna, Inc., sued Laboratory Corporation of America in federal court, seeking injuctive relief for actions taken once LabCorp became an out-of-network laboratory provider for Aetna in July 2007. LabCorp is also accused of a “malicious scheme to continue to receive …
AG Jerry Brown Settles With Westcliff Med Labs
CEO SUMMARY: In California, Attorney General Jerry Brown is making progress in the whistleblower lawsuit alleging that seven lab companies in California violated state law by not giving Medi-Cal, the state’s Medicaid program, the same lowest lab test prices they extend to physi…
PhyTest Assists Doctors With Lab Testing Revenue
CEO SUMMARY: PhyTest, Inc., created a unique business model upon its founding in 1998. It primarily specializes in handling laboratory test billing and collection services to office-based physicians. It also provides evaluation, consulting, and implementation services to help physicians i…
Defense Attorneys Discuss Details Of UroCor Jury Trial
CEO SUMMARY: This was the first criminal case involving anti-kickback violations brought against executives of a public laboratory company. Federal prosecutors charged the defendants with offering inducements to referring physicians in several ways. Defense counsel rebutted the prosecutio…
OIG Moves to Address “Usual Charge” Issue
CEO SUMMARY: Federal regulators are taking another crack at defining “usual charges.” Language in the proposed rules published last month precisely defines which payers should be included in determining “usual charges” and what charge basis to use for specific payers. Once effecti…
Will “Free Testing” Ploy Financially Affect Labs?
CEO SUMMARY: It’s a marketing scheme which public lab companies have quietly used for years. Now there is evidence that the use of “Waiver of Charges to Managed Care Patients” (free testing) seems to be on the increase, raising new questions about how and why competitive practices a…
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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