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Delay and Fix Is Message From Labs to Congress

CEO SUMMARY: Only a few months remain before the federal Centers for Medicare and Medicaid Services makes deep price cuts to Medicare Part B clinical laboratory test fees. Before those cuts go into effect, lab associations and lab professionals are educating members of Congress and the ne…

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2014’s PAMA Fix Comes Back to Haunt Big Labs

AS YOU READ THE INTELLIGENCE BRIEFINGS IN THIS ISSUE about lab industry efforts to convince Congress, the administration, and the new leaders of the Centers for Medicare and Medicaid Services to delay implementation of the PAMA final rule on market price reporting, keep in mind thatâ…

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Hospital Lab Data Essential For CMS Market Price Study

CEO SUMMARY: In five months, Medicare officials will implement a new Part B clinical laboratory fee schedule based on private payer lab price data submitted by certain medical laboratories required to report that data. At this year’s Executive War College, the CEO of XIFIN, Inc., reported o…

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CMS Extends Reporting of Payer Prices by 60 Days

CEO SUMMARY: Last Thursday, the federal Centers for Medicare and Medicaid Services said it was extending the deadline for certain labs to report their private payer lab test prices by an additional 60 days, until May 30. Statements by CMS officials indicate that either or both the number …

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Clinical Labs Bidding Up Lab Director Salaries

CEO SUMMARY: There’s great news for pathologists and PhDs with expertise in molecular and genetic testing. Salaries are on the rise as more clinical labs build up their molecular and genetic testing programs and need talent to implement and supervise this activity. One experienced medic…

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PAMA Data Projections Led to Decision to Sell Lab

CEO SUMMARY: Following passage of the Protecting Access to Medicare Act of 2014, officials at PeaceHealth and PeaceHealth Laboratories began to model the financial effect this law would have on this long-established hospital lab outreach program. Based on projections of a 20% cut in reven…

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Lab Innovators Advocate Need for Clinical Lab 2.0

CEO SUMMARY: It is generally recognized that the clinical lab industry faces a financial squeeze of unprecedented dimensions. Lab test prices are falling steadily and more major cuts are coming to Medicare Part B fees in just 11 months. At the same time, obtaining favorable coverage and r…

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PAMA Economics Drives Merger Of Two Seattle-Area Pathology Groups

CEO SUMMARY: Among the three chief reasons for the merger of CellNetix and Puget Sound Institute of Pathology, the most compelling was the need to address the challenges in the current reimbursement environment and to prepare for reductions in payment to pathologists expected in the comin…

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UHC, LabCorp Play Hard Ball With Texas Lab Contracts

CEO SUMMARY: In launching BeaconLBS in Texas, UnitedHealthcare included a new, more onerous twist than it used for BeaconLBS in Florida. To be a BeaconLBS in-network ‘lab of choice,’ a lab must be in the lowest quartile for lab test prices. Any lab above the 25th percentile would have…

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California’s Lab Price Data Collection Project Cuts Lab Test Prices by 10.5%

COLLECTING LAB TEST PRICE DATA is not limited to PAMA and the federal Centers for Medicare & Medicaid Services. California’s Medi-Cal program is in its second year of requiring clinical labs to submit private payer lab test price data. However, in both the fir…

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