TAG:
laboratories
UHC, LabCorp Play Hard Ball With Texas Lab Contracts
CEO SUMMARY: In launching BeaconLBS in Texas, UnitedHealthcare included a new, more onerous twist than it used for BeaconLBS in Florida. To be a BeaconLBS in-network ‘lab of choice,’ a lab must be in the lowest quartile for lab test prices. Any lab above the 25th percentile would have…
PAMA Reporting Penalties Can Be Substantial for Laboratories
STARTING JAN. 1, 2017, there are substantial penalties for labs that fail to properly meet the complex lab test price marketing reporting requirements of the Protecting Access to Medicare Act of 2014. Labs that fail to do so face the potential of stiff, multi-million dollar fines. “Under PAMA, cli…
Much Disruption for Labs In 2016’s Top 10 Stories
CEO SUMMARY: Within THE DARK REPORT’S list of the Top 10 Lab Industry Stories for 2016 is one story of disruption that might have been one story of disruption about to happen. The disintegration of Theranos during 2016 is the big story about a self-proclaimed disruptor of the lab indust…
OIG Comments on PAMA Plan and Exclusion of Many Labs from Reporting
ON THE SUBJECT OF LAB TEST MARKET PRICE REPORTING as required under PAMA, many clinical laboratory executives, pathologists, and industry experts see deep flaws in the process the federal Centers for Medicare & Medicaid Services has established. Yet, CMS itself seems blind to the…
Labs Discover Much Complexity In Their Lab Test Price Data
DON’T EXPECT IT TO BE EASY AND STRAIGHTFORWARD when reporting the prices of chemistry panels as the final rule for lab test market price reporting rule requires. Instead, labs should expect the process to be complex and troublesome. Also, labs should be concerned that Medicare officials have threa…
Expert Explains Why Payer Errors Skew Labs’ PAMA Price Data
CEO SUMMARY: In its work with more than 200 lab clients, XIFIN, Inc., of San Diego, sees the best and worst of problems in how labs submit claims to lab tests and how payers process these claims. In this exclusive interview, Lâle White, XIFIN’s Founder and CEO, identifies the systemic …
Widespread payer errors will cause headaches as Protecting Access to Medicare Act of 2014 price reporting comes due
This is an excerpt from a 2,700-word article in the November 28Â 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. …
Should Labs File Court Challenge To PAMA Price Report Rule?
CEO SUMMARY: Just four weeks remain before CMS begins collecting private payer clinical laboratory test price data. Many lab industry executives have charged that Medicare officials are not following the language of the PAMA statute or the intent of Congress. At stake are $5.4 billion in …
Will Coming Medicare Fee Cuts Reduce Access to Laboratory Tests?
SEVERAL IMPORTANT clinical laboratory associations are concerned that the lab test price reporting under the Patient Access to Medicare Act of 2014 will have a negative effect on diagnostic innovation and on Medicare beneficiaries’ access to lab testing services. The American Clinical Laboratory A…
California’s Lab Price Data Collection Project Cuts Lab Test Prices by 10.5%
COLLECTING LAB TEST PRICE DATA is not limited to PAMA and the federal Centers for Medicare & Medicaid Services. California’s Medi-Cal program is in its second year of requiring clinical labs to submit private payer lab test price data. However, in both the fir…
CURRENT ISSUE
Volume XXXII, No. 13 – September 15, 2025
The Dark Report examines a new bill that would reform PAMA and avoid reimbursement rate cuts scheduled for January 2026. Clinical laboratory leaders are urged to make their voices heard in Congress. Also, an expert describes how labs can fix pre-analytical errors and avoid disaster.
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