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CMS Proposes Sanctions Against OSU Laboratory

CEO SUMMARY: As its reward for self-reporting the referral of six proficiency testing (PT) specimens in three years, the laboratory at Ohio State University Wexner Medical Center (OSUWMC) has been told by the Centers for Medicare & Medicaid Services (CMS) that its CLIA license could b…

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Existing CLIA Language Drives PT Enforcement

CEO SUMMARY: Revocation of a lab’s CLIA license as penalty for inadvertent errors in handling proficiency tests (PT) is not a new problem. As explained here, most clinical laboratories have appropriate protocols for handling PT samples. But, when errors occur, the Centers for Medicare &…

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CMS and CAP Comment On CLIA PT Matters

CEO SUMMARY: Federal regulators rely on interpretations from administrative law judges (ALJ) for guidance in how to apply the Clinical Laboratory Improvement Amendments (CLIA) as they pertain to proficiency testing (PT) and the issue of inadvertent PT referrals. Representatives of the Cen…

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Congress May Respond to Tough CLIA PT Penalties

CEO SUMMARY: For years, severe penalties in cases where a laboratory has inadvertently erred in handling proficiency testing (PT) specimens have been a point of contention between the Centers for Medicare & Medicaid Services (CMS) and the clinical laboratory profession. Two bills prop…

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Blue Cross Execs Discuss Reasons for New Policies

CEO SUMMARY: In recent months, officials from the Blue Cross and Blue Shield Association (BCBSA) have responded to the concerns about new billing protocols for services provided as part of the BlueCard program and voiced by such clinical lab associations as the California Clinical Laborat…

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Employers, Payers Are Challenging ‘High’ Test Prices

ONE NATIONAL TREND IN CLINICAL LABORATORY TESTING that has not yet gotten wide play outside the pages of THE DARK REPORT is the emergence of what might be termed a “war” by national and regional health insurers against the “higher” prices often charged by hospital laboratories. This is a key…

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July 16, 2012 “Intelligence : Late Breaking Lab News”

It is with sadness that we report the death of pathologist Joel A. Sonnier, M.D. A victim of murder, his body was discovered in his home in Lubbock, Texas, on July 10. The housekeeper and the gardener made the discovery and called the police. Lubbock police announced the murder, but have no suspects …

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Florida Law Better Defines Lab Marketing Violations

CEO SUMMARY: Despite clear language in Florida’s new state law that bans the placement of laboratory employees in a physicians’ office, some clinical lab companies want to continue the practice of placing specimen collectors in physicians’ offices. These opinions were voiced by lab …

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Lab Site Visits in NZ Show Impact of Lab Contracting

CEO SUMMARY: In some ways, the story of the New Zealand’s health system’s 15-year strategy to reduce the cost of clinical laboratory testing is a cautionary tale for public laboratory companies in the United States. During THE DARK REPORT’S site visit to several private labs in New …

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New BlueCard Policies Affect Lab Test Claims

CEO SUMMARY: This new policy from the Blue Cross and Blue Shield Association (BCBSA) becomes effective on October 14, 2012. No longer can a local lab provide service to a member under the BlueCard program and be paid by the local plan in the region where the service was provided….

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