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Labs Serving Nursing Homes, Rural Areas to Suffer Most

CLINICAL LABORATORIES WITH A HIGH percentage of Medicare Part B lab test reimbursement are expected to suffer the most under the Part B Clinical Laboratory Fee Schedule (CLFS) cuts that the Centers for Medicare and Medicaid Services proposed Sept. 22. With the proposed rates schedul…

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Can Fee Cuts Be Delayed? Courts Are One Option

CEO SUMMARY: Some lab companies may be prepared to challenge in court the methodology CMS used in setting the requirements of the Protecting Access to Medicare Act of 2014 to conduct a study of private payer market prices for lab tests and use that data to propose new prices for the Part …

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Here Are the Arguments When Commenting on 2018 CLFS Rates

ALL LABORATORY PROFESSIONALS AND pathologists are encouraged to submit comments to CMS before the Oct. 23, as well as send letters to their elected officials in Congress to urge both to delay and to fix the market price study and revise the proposed Clinical Laboratory Fee Schedule for 2018. Bene…

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Lab Associations Comment on CMS Actions, Lab Fees

FOR THE LAB INDUSTRY, THE FEE CUTS proposed in the 2018 Clinical Laboratory Fee Schedule would be even more aggressive than what the federal Centers for Medicare and Medicaid Services had earlier predicted for Medicare Part B. In the days following the Sept. 22 publication of the pr…

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NYU Langone and Sonic Healthcare Create Laboratory Outreach Joint Venture

CEO SUMMARY: NYU Langone Health recognized the clinical and financial advantages of providing competitive lab outreach testing services to its employed physicians. The laboratory joint venture with Sonic Healthcare USA will allow NYU Langone to increase use of its hospital labs and will f…

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Positive Patient ID System Catches Patients Cheating on Toxicology Tests

CEO SUMMARY: The urine drug testing industry is challenged every day to detect the large number of patients trying to cheat on their drug tests. GenoTox Laboratories of Austin, Texas, developed a DNA-authentication method for urine samples that allows the lab to detect when patients have …

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UnitedHealth to Start Gene Test Pre-Approval

CEO SUMMARY: With programs now at the nation’s two largest insurers, is it possible to argue that prior-authorization is going mainstream? Some observers say, yes, as THE DARK REPORT predicted. What is certain is that starting Nov. 1, UnitedHealthcare is requiring prior authorization fo…

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Estimating Total Costs When Genetic Tests Must Be Retested

INVITAE, A GENETIC TESTING COMPANY IN San Francisco, has begun a retest program involving 50,000 patients. Such a large retest effort is without precedent in the still-nascent genetic testing marketplace. Clinical laboratories and genetic testing companies commonly find that, in dai…

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Time’s running out to stop Medicare lab fee schedule cuts

This is an excerpt from an article in the August 7, 2017 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. CEO SUMMARY: Only a few mo…

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NILA Asks Labs to Speak about PAMA Rule’s Flaws

CEO SUMMARY: In a call to action, the National Independent Laboratory Association is urging lab owners, lab managers, and pathologists to educate their members of Congress about the biases and deep flaws built into the final rule for PAMA market price reporting and how the rule will resul…

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