Why Many Patients Cannot Pay for Their Lab Tests

By R. Lewis Dark | From the Volume XXX, Number 15 – October 23, 2023 Issue

IT IS WIDELY RECOGNIZED THAT GOVERNMENT AND PRIVATE PAYERS STEADILY NIBBLE AWAY at what they reimburse clinical laboratories and anatomic pathologists. Lowering the prices paid for tests, excluding labs from networks, and declining to grant coverage for new lab tests are just a few of the tactics use…

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Getting Payer Coverage for New Tests Continues to Be Difficult

By Robert Michel | From the Volume XXVIII, No. 8 – June 14, 2021 Issue

EVERY YEAR, IT BECOMES TOUGHER FOR CLINICAL LABORATORIES WITH NEW GENETIC AND OTHER TESTS to obtain favorable coverage decisions by government and private payers.  Not only does it take longer to get a decision from a payer, but payers today want to see …

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Predicting Future Demand for COVID-19 Testing

By Robert Michel | From the Volume XXVIII, No. 7 – May 24, 2021 Issue

CEO SUMMARY: After 15 months of the pandemic, the nation’s clinical laboratories are at an interesting crossroads. Is the COVID-19 outbreak diminishing and close to disappearing? Or might it intensify again, particularly when the traditional influenza season arrives next fall? The…

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Restitution and Guilty Plea in Two Lab Fraud Cases

By Robert Michel | From the Volume XXVIII No. 5 – April 12, 2021 Issue

CEO SUMMARY: In one case, owners and a sales rep agreed to pay restitution totaling almost $10 million. In the second case, three defendants pled guilty to federal charges involving payment or receipt of kickbacks and illegal inducements. A fourth defendent in this second case, a ph…

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April 12, 2021 Intelligence: Late-Breaking Lab News

By Robert Michel | From the Volume XXVIII No. 5 – April 12, 2021 Issue

One clinical laboratory company now says it provides COVID-19 testing services to all five of the major men’s professional sports leagues in the United States. On April 1, BioReference Laboratories, Inc. (BRLI), a division of Opko Health, announced a new agreement with Major League…

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What Comes Next? Predictions on COVID-19 Test Volumes in 2021-22

By Robert Michel | From the Volume XXVIII, No. 4 – March 22, 2021 Issue

CEO SUMMARY: Incoming data show that the number of referrals for both COVID-19 tests and routine tests is in a decline that started in October and is continuing. This complicates the strategic planning for hospital/health system labs, independent labs, and pathology groups. They nee…

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New Year Brings Three New Clinical Lab Trends

By Robert Michel | From the Volume XXVIII No. 3 – March 1, 2021 Issue

CEO SUMMARY: Since the year began, three trends have affected clinical laboratories and anatomic pathology groups. First is a continuing surge in COVID-19 test volume. Second is inconsistent payment from government and commercial insurers for SARS-CoV-2 test claims. Third is growing…

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Pathology Lab Transforms, Runs 1M COVID-19 Tests

By Robert Michel | From the Volume XXVIII No. 3 – March 1, 2021 Issue

CEO SUMMARY: Last spring, a histopathology lab in Illinois began running molecular COVID-19 tests and decided the clinical side of the lab would focus exclusively on PCR testing for COVID-19. The challenge was how to access a reliable source of test kits, reagents, and supplies to o…

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January 19, 2021 Intelligence: Late-Breaking Lab News

By Robert Michel | From the Volume XXVIII, No. 1 – January 19, 2021 Issue

Just days ago, the federal Food and Drug Administration (FDA) issued updated information about the COVID-19 tests it has authorized since early in the pandemic. As of Jan. 15, 2021, the agency had authorized a total of 317 tests for the SARS-CoV-2 coronavirus. Included in this total are 236 mo…

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UK Postpones Mass COVID Testing Plan Due to Questions of Accuracy

By Robert Michel | From the Volume XXVII, No. 18 – December 28, 2020 Issue

IN THE UNITED KINGDOM, A MASS COVID-19 TESTING PLAN called “Operation Moonshot” is on hold until at least the end of January. Under the plan, health ministers sought to increase daily SARS-CoV-2 testing from 430,000 to 10 million Englanders per day.  …

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