TAG:
laboratory benefit management
July 10, 2023, Intelligence: Late-Breaking Lab News
General health panels submitted under CPT code 80050 are among the most expensive—and potentially most wasteful—diagnostic tests, according to a new study published in June by Avalo…
Optum and Avalon Discuss Genetic Test Claims Review
CEO SUMMARY: With the ever-increasing number of genetic tests on the market, payers are understandably frustrated with genetic test claims that don’t clearly outline the medical need for a procedure or it…
Six Important Themes to Help Labs Succeed
CEO SUMMARY: Clinical laboratories face business challenges with day-to-day operations, genetic testing, and evolving care delivery models. The 2023 Executive War College on Diagnostics, Clinical Laboratory, and Pathology Management returns on April 25-26 in New Orleans. Participant…
Lab Benefit Managers Want to Help Health Plans
CEO SUMMARY: Laboratory benefit management companies that offer a range of services to health insurers are gaining influence over clinical lab testing in important ways. On behalf of health insurers, LBMs will select labs for a payer’s network, then manage that network. They also manage…
Prediction of ICD-10 as Negative for Labs Comes True
IMPLEMENTATION OF ICD-10 DIAGNOSIS CODES in the United States happened on Oct. 1, 2015. At that time, a national laboratory association predicted that use of ICD-10 codes would cause Medicare Administrative Contractors (MACs) to pay labs less often and with lower reimbursement. The Dark Report ag…
Lower Prices, More Data in UHC’s New Lab Network?
CEO SUMMARY: It’s been a common strategy among managed care payers to seek the lowest prices for clinical laboratory testing when negotiating contracts with labs. However, lower prices may become less important over time as the health system moves away from fee-for-service payment towar…
Strategies to Offset Medicare Cuts to Be Shared at Exec. War College
DEEP PRICE CUTS to the Medicare Part B Clinical Laboratory Fee Schedule was the big story of 2017. The big story of 2018 may be the widespread financial disruption to the clinical lab industry as labs see dramatic declines in their revenue from these Medicare fee cuts. One early opportunity for lab …
CURRENT ISSUE
Volume XXXI, No. 16 – November 25, 2024
Two different federal lawsuits that challenge the authority of the federal Food and Drug Administration (FDA) to regulate laboratory developed tests (LDTs) will be combined. Plaintiffs and the government in both cases agreed to move forward on this basis.
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