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April 15, 2013 “Intelligence: Late Breaking Lab News”

Geisinger Health System broke ground last month on construction of a new $52 million medical laboratory facility. It will be 115,000 square feet and will be located at the site of the Geisinger Medical Center in Danville, Pennsylvania. LAB COMPANY COMPLET…

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Anticipating Washington’s Next Blows to Lab Testing

CEO SUMMARY: With the advent of 2013, almost every lab was responding to some type of price cut. Clinical labs are dealing with the sequential, multi-year cuts to the Medicare Part B Lab Test Price Schedule. Anatomic pathology labs are still adjusting to the expiration of the TC Grandfath…

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Urologists Weigh in on Prostate Biopsy Testing

CEO SUMMARY: Based on an impressive number of 4,230,129 vials collected from 437,937 biopsies, the new study is expected to add fuel to the fire of the ongoing debate about the appropriate number of prostate biopsies physicians should collect and refer to pathology labs for cancer testing…

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Palmetto’s Prostate Biopsy Policy Removed after Talks with CMS

THERE IS SOME POSITIVE LAB INDUSTRY NEWS that has not been widely reported yet. It involves a decision to change an unwelcome Medicare policy that limited the number of prostate biopsy specimens per case that would be reimbursed. After discussions between lab industry groups and the federal …

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Low 2013 Molecular Rates May Bankrupt Some Labs

CEO SUMMARY: Many of the recently issued reimbursement rates for molecular diagnostic tests are inadequate and in fact are lower than the cost of running the tests, lab experts say. Smaller laboratories that specialize in developing and selling molecular tests could be forced to close. As…

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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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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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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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MD Self-Referral Issues Target of Utilization Study

CEO SUMMARY: When it comes to the in-office ancillary service (IOAS) exception to physician self-referral, the issue of in-clinic pathology services has become a hot potato. Publication in Health Affairs of a study of urologists’ self-referral of their patients for anatomic pathology se…

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Hospitals Get Bad News Re: TC Grandfather Expire

CEO SUMMARY: During negotiations to extend the payroll tax cut in February, Congressional negotiators agreed to end the technical component (TC) grandfather provision for more than 1,000 rural hospitals. Seeking to save $50 million annually, Congress said anatomic pathologists would no lo…

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