TAG:
laboratories
Paper Requisition Signature Rule Contradicts 2001 Actions
CEO SUMMARY: Last year, the Centers for Medicare and Medicaid Services (CMS) used publication of the proposed 2011 Medicare Physician Fee Schedule to introduce new language that would require, as of January 1, 2011, that all paper requisitions for clinical laboratory tests for Me…
More Reimbursement Threats for Lab Testing
WE ARE NOW WELL INTO THE FIRST MONTH OF 2011 and already there are plenty of signs that reimbursement for both clinical laboratory testing and anatomic pathology testing will come under siege from a variety of sources this year. Take, for example, the rather rapid action by the Centers for M…
Pursuing More Benefits From Next Generation Lab Automation
CEO Summary: Once it was decided to replace an aging, five-year-old laboratory automation system at the laboratory of Ingalls Memorial Hospital in Harvey, Illinois, the administration at the hospital issued a challenge. It asked the laboratory team to deliver an immediate 10% cos…
Who Wins and Who Loses With 51501 Enforcement
CEO SUMMARY: Assume that California’s Department of Health Care Services (DHCS) wins all challenges to enforcement of its interpretation of 51501(a). DHCS will get a one-time cash infusion as it collects money from labs which violated the state statute. But going forward, feder…
December 27, 2010 “Intelligence: Late Breaking Lab News”
As the year ends, a bit of humor is in order and the recent dust-up involving Michael Moore’s healthcare documentary, titled “Sicko,” and a State Department cable posted on wikileaks.com may be just the item. About a week ago, The Guardian newspaper in Manchester, England, rep…
Did Qui Tam Suit Trigger Medi-Cal Price Concerns?
CEO SUMMARY: It is easy to track backwards to understand why the California Department of Healthcare Services (DHCS) began aggressive enforcement of its interpretation of statute 51501(a) against a number of labs this summer. DHCS officials were given a full education and a roadm…
Calif. Officials Back Off From Suspending Labs
CEO SUMMARY: Early in the summer, California’s Department of Health Care Services (DHCS) delivered letters to between 10 and 30 laboratory companies notifying them that, effective immediately, it was withholding their Medi-Cal payments and was suspending each lab’s Medi-Cal l…
Discounted Lab Prices Become Issue in California
CEO SUMMARY: For decades, California’s lab testing market has been considered the Wild West because clinical lab companies have felt relatively free to offer deeply-discounted prices to expand market share and take business away from competitors. Now these discounted pricing pr…
Any Future for Loss-Leader Lab Pricing?
OUTSIDE OF CALIFORNIA, few pathologists or laboratory administrators are aware of the unfolding enforcement campaign that was initiated by the state’s Medi-Cal program. At issue is a decades-long practice of offering providers low laboratory test prices—in some cases well below the Medi-Cal fee …
How Could So Many Labs Violate California Law?
CEO SUMMARY: If a 40-year-old state law on Medi-Cal pricing was known to regulators and clinical laboratories alike, how did the legal and compliance departments of so many laboratories—staffed by some of the smartest legal minds in California and nationally—interpret the law…
CURRENT ISSUE
Volume XXXII, No. 14 – October 6, 2025
The Dark Report examines increasing healthcare costs for employers and how clinical labs can help those employers. Also, an in-depth case study shows how one hospital system regained its outreach program after originally ceding it to a national lab company, adding millions to the system’s bottom line.
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