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July 08, 2013 “Intelligence: Late Breaking Lab News”

In China, independent clinical laboratories are in a fast-growth mode. That’s the conclusion of RnRMarketResearch in a newly-issued survey of the clinical laboratory testing market in China. It estimates this market segment at US$407 million annually. RnR says that three lab companies meet …

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Aetna Threatens to Expel Docs for Out-of-Network Lab Referrals

MANAGED CARE PLANS are taking aggressive steps to keep clinical lab testing within their preferred networks. In particular, Aetna, Inc., is earning a reputation as one of the toughest insurers in this regard. Most recently, in a letter sent to at least one network physician, Aetna w…

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Medicare Contractor’s Ruling on MolDx Test Causes Lab to Close

CEO SUMMARY: On May 14, Predictive Biosciences learned that its Medicare contractor had determined that one of its three molecular tests for bladder cancer was a screening test. It also never got a determination on its other two molecular tests. Because Medicare is half of the lab’s pay…

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BlueCard Policy Causing Clinical Labs to Go Unpaid

CEO SUMMARY: Clinical laboratories doing lab test work for Blue Cross Blue Shield patients using their BlueCard benefit are no longer being paid by the Blues plans. Some Blues plans are sending those reimbursement checks directly to their members with instructions for the patient to use t…

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Hospital System Acquires Labs In ACO Strategy

CEO SUMMARY: Moving to deliver services as an accountable care organization (ACO), Genesis Health System of Davenport, Iowa, has acquired the laboratory assets in two hospitals previously operated by Metropolitan Medical Laboratory, PLC, a lab company owned by local patho…

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Lab Landscape Changing as ACOs Get Started

FOR THOSE OF YOU INTERESTED IN HOW the development of accountable care organizations (ACOs) in a community causes a realignment among providers and the clinical laboratories serving them, I offer you the example of Genesis Health System in Davenport, Iowa. As you will read …

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TriCore Lab Adds Value with Consults, Better TAT

CEO SUMMARY: Motivated by the goal of delivering more value to clinicians and client hospitals, the lab team at TriCore Reference Laboratories in Albuquerque, New Mexico, is proactively introducing new services. One such initiative is to travel to hospitals to participate in rounds and co…

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Labs Face Consequences from MolDx Test ‘Mess’

CEO SUMMARY: Non-payment of molecular test claims for the first five months of 2013 is not the only financial disruption for labs that perform these tests. Reports are coming in about how Medicare contractors, Medicaid programs, and private payers are declining to pay claims based on ruli…

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Why a Divided Lab Industry May Soon Fall

OVER THE PAST TWO DECADES, it has often been remarked on these pages and by many others that the divided nature of the laboratory medicine profession will prove to be its ultimate Achilles heel. These divisions center around different scientific disciplines within pathology and lab medicine as well a…

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OIG Tells CMS It Could Save $910 Million on Lab Test Costs

IT IS ONE MORE POWERFUL SIGN of the changing times. Last week, the Office of the Inspector (OIG) publicly released a study it had done of the prices paid for lab testing and how the Medicare program could use this information to reduce the cost of Part B clinical laboratory testing. It was The W…

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