TAG:
lab test
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…
Revisiting the ‘Substantially in Excess Rule’
BY NOW, NEARLY EVERY LAB MANAGER knows that Medicare lab test fee cuts will commence in just 13 months, on Jan. 1, 2018. The federal Centers for Medicare & Medicaid Services estimates that the f…
OIG Comments on PAMA Plan and Exclusion of Many Labs from Reporting
ON THE SUBJECT OF LAB TEST MARKET PRICE REPORTING as required under PAMA, many clinical laboratory executives, pathologists, and industry experts see deep flaws in the process the federal Centers for Medicare & Medicaid Services has established. Yet, CMS itself seems blind to the…
Should Labs File Court Challenge To PAMA Price Report Rule?
CEO SUMMARY: Just four weeks remain before CMS begins collecting private payer clinical laboratory test price data. Many lab industry executives have charged that Medicare officials are not following the language of the PAMA statute or the intent of Congress. At stake are $5.4 billion in …
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…
Will Coming Medicare Fee Cuts Reduce Access to Laboratory Tests?
SEVERAL IMPORTANT clinical laboratory associations are concerned that the lab test price reporting under the Patient Access to Medicare Act of 2014 will have a negative effect on diagnostic innovation and on Medicare beneficiaries’ access to lab testing services. The American Clinical Laboratory A…
Expert Explains Why Payer Errors Skew Labs’ PAMA Price Data
CEO SUMMARY: In its work with more than 200 lab clients, XIFIN, Inc., of San Diego, sees the best and worst of problems in how labs submit claims to lab tests and how payers process these claims. In this exclusive interview, Lâle White, XIFIN’s Founder and CEO, identifies the systemic …
Widespread payer errors will cause headaches as Protecting Access to Medicare Act of 2014 price reporting comes due
This is an excerpt from a 2,700-word article in the November 28Â issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. …
Could Community Labs Become Extinct after PAMA?
IN THE PURSUIT OF IMMEDIATE COST SAVINGS, our federal government may be about to tinker with an essential clinical service in ways that will severely harm patients in rural areas and small towns throughout the United States. Specifically, will the final rule to implement PAMA lab test market price r…
Why Small Labs and Even Hospitals Are at Risk from PAMA Cuts
CEO SUMMARY: Clinical lab executives and experts who have studied the final rule for PAMA lab test market price reporting are seriously concerned that the design of this rule may put many of the nation’s smallest, but still essential, clinical labs at great risk of financial distress, i…
CURRENT ISSUE
Volume XXXII, No. 12 – August 25, 2025
In an exclusive interview, a laboratory industry M&A specialist discusses what’s driving lab outreach sales to national lab companies. Also, The Dark Report analyzes ways in which pathology and clinical labs can profitably partner with pharmaceutical companies.
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