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Labs Get High Denial Rates Under New NCCI Rules

CEO SUMMARY: Under guidelines the National Correct Coding Initiative issued last year, many clinical laboratories are not getting paid for some tests. The rates of denial for labs running mostly molecular tests could range from 40% to 100% of revenue, one billing expert said. Implemented …

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ACLA: NCCI Guidelines Are a ‘Step Backwards’

CEO SUMMARY: In a letter to the National Correct Coding Initiative, the American Clinical Laboratory Association (ACLA) raised significant concerns about new language in the policy manuals for Medicare and Medicaid. ACLA said the new NCCI guidelines for molecular and other tests requiring…

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Nine Lab Groups Say New NCCI Policy Is Inconsistent

CEO SUMMARY: By its name alone, the National Correct Coding Initiative (NCCI) Policy Manual implies that it will be accurate and consistent with other coding initiatives. But nine groups representing various clinical laboratories say NCCI guidelines that the federal Centers for Medicare a…

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Reacting to PAMA Cuts, Lab Works with Payers

CEO SUMMARY: Before Medicare’s lab test price cuts went into effect last year, Health Network Laboratories began discussions with private health insurers and nursing home clients about the possibility of renegotiating their contracts. In these discussions, HNL promoted the value it deli…

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COLA: GAO Should Address PAMA’s Effect on Patients

CEO SUMMARY: In a recent statement, COLA, an organization that accredits clinical labs, expressed strong concern about how a report from the Government Accountability Office did not address how the Protecting Access to Medicare Act of 2014 (PAMA) affects patients’ access to testing, esp…

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LIS-EHR Fees Increasing, Say Hospital Lab Execs

CEO SUMMARY: Hospital and health system lab managers say some vendors of electronic health record systems for independent physicians are aggressively raising the fees they charge labs. Labs serving outreach physicians now pay more in two ways, they say. First, they pay the price the vendo…

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For Labs, Blockchain Offers New Opportunities

CEO SUMMARY: Some of blockchain’s proponents view its potential uses in health information technology to combat cybersecurity threats and improve the secure exchange of health information through electronic medical record systems. But for clinical laboratories, blockchain could be the k…

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PAMA Price Cuts Reduce Revenue at Two National Labs

This is an excerpt from a 1,500-word article in the Feb. 25, 2019 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: In their respective earnings reports for the fourth quarter and the full year of 2018, executives at both La…

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PAMA Price Cuts Reduce Revenue at LabCorp, Quest

This story was updated from the original on March 27, 2019, and includes corrected information in three places. CEO SUMMARY: In their respective earnings reports for the fourth quarter and the full year of 2018, executives at both Laboratory Corporation of America and Quest Diagno…

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Northwell Health Builds Two Big Lab Facilities

CEO SUMMARY: At Northwell Health, the clinical laboratory team has been busy building and opening two new, large laboratory facilities. First to open was the lab in Little Neck, Queens, a shared lab with NYC Health and Hospitals. This lab will handle 36 million tests annually. The second …

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