TAG:
lab tests
Pathologists Contribute To Care in Wisconsin ACO
CEO SUMMARY: From the launch in 2013 of a big accountable care organization in Wisconsin, the North Shore Pathologists at Columbia-St. Mary’s Hospital have been involved. Among the lessons learned are the importance of structuring the pathology contract with the hospital to antic…
Florida Doc Says Questions Go Unanswered by UHC
CEO SUMMARY: One common complaint about the efforts of UnitedHealthcare to introduce its unpopular laboratory benefit management program in Florida is that the insurer-and its agent, BeaconLBS, a division of Laboratory Corporation of America-don’t respond to physicians when they …
Benchmarking with the Best To Be a World Class Laboratory
CEO SUMMARY: This fourth installment of this special series about the laboratory value pyramid introduces “Level Four: Use Benchmarks to Achieve Best-in-Class.” This is the highest level of the four level pyramid. When a lab organization performs at this level, it will be deliver…
Beware Ides of March! Lawmakers Are in Session
CEO SUMMARY: Few pathologists and lab administrators know that, when the Protecting Access to Medicare Act of 2014 (PAMA) became law last April 1, language in the bill was scored to reduce Part B clinical laboratory test fees by $2.5 billion over 10 years. Congress used those lab…
Locked Out of Payer Network, NH Hospital Opens Lab Company
CEO SUMMARY: Since Anthem launched its site of service program in New Hampshire in 2010, labs in the state’s hospitals have mostly been excluded from its network and have lost market share. Recently one community hospital developed an unusual strategy to win back those patients…
UnitedHealth Sets April 15 to Start Claims Impact of Lab Program
APRIL 15 IS THE DATE when UnitedHealthcare will begin denying laboratory claims in Florida that do not meet the requirements of its unpopular laboratory benefit management program. The health insurer sent out notices last month to alert physicians and laboratories that it will implement what it call…
Florida Doctors Refuse to Use UHC’s Lab Ordering System
CEO SUMMARY: It may not yet be open rebellion, but UnitedHealthcare faces strong opposition in Florida from physicians- and their medical societies-over the requirement that they obtain pre-notification and pre-authorization when ordering tests listed in UHC’s laboratory benefit …
Protecting Access to Medicare Act of 2014 Could Harm Independent Community Labs
In the Protecting Access to Medicare Act of 2014 (PAMA), the Center for Medicare and Medicaid Services (CMA) is directed to collect market price data and use the data to establish prices for the Medicare Part B Clinical Laborato…
Market Price Report Rules Must Address All Issues
CEO SUMMARY: Under the Protecting Access to Medicare Act, CMS must collect market price and volume data from certain labs beginning January 1, 2016. CMS will use this data to establish Part B clinical laboratory fees beginning in 2017. One lab association representing community a…
Florida Lab Story Has National Implications
PLEASE ALLOW ME TO THANK ALL OF YOU READERS who have contacted us with information, rumors, and useful intelligence about UnitedHealthcare’s laboratory benefit management program in Florida that is administered by BeaconLBS, a division of Laboratory Corporation of America. Your input, along with tha…
CURRENT ISSUE
Volume XXXII, No. 7 – May 12, 2025
Economic, Tech changes drive lab concerns, The Dark Report provides insights from the Executive War College speakers about how clinical labs can use business strategies and tactics to handle the new tariffs, future regulations, and artificial intelligence (AI). Also, this issue provides guidance on how labs and pathologists should prepare for payer audits.
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