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August 19, 2013 “Intelligence: Late Breaking Lab News”

There is a billion-dollar laboratory acquisition underway in Ontario, Canada. LifeLabs Medical Services is moving ahead with its planned purchase of CML HealthCare for US$917 million. The deal was made public on June 25 and, because it represents a major consolidatio…

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Labs Face Consequences from MolDx Test ‘Mess’

CEO SUMMARY: Non-payment of molecular test claims for the first five months of 2013 is not the only financial disruption for labs that perform these tests. Reports are coming in about how Medicare contractors, Medicaid programs, and private payers are declining to pay claims based on ruli…

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Aetna To Lower Lab Test Prices, New Fees Are Effective on July 1

IN RECENT MONTHS, labs are reporting the receipt of letters from Aetna, Inc., announcing that it will pay dramatically less than Medicare prices for many key lab tests. Aetna said that these lower prices will take effect on July 1, 2013. Three examples illustrate the deep fee cuts t…

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How CMS ‘Mismanaged’ Pricing of Molecular Tests

CEO SUMMARY: CMS and its contractors had ample opportunity to implement a new reimbursement system but failed to act in a timely manner, stated an expert familiar with the problem. The result is that laboratories, particularly those that have one or two proprietary molecular tests, are be…

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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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Intermountain Seeks Shared Accountability

CEO SUMMARY: Intermountain Healthcare is one of the nation’s largest and most respected institutions. Its quality improvement efforts are well documented. Intermountain is pursuing an ambitious goal to limit cost increases to the rate of inflation. To reach this goal, every clinical dep…

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Anticipating 2013 Trends in Clinical Lab and Pathology

CEO SUMMARY: Biggest news for 2013 will the impact of significant price cuts for both clinical lab and anatomic pathology testing services. But the bad news doesn’t stop there. Employers and private payers will be more aggressive in taking steps to reduce what they spend on lab testing….

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Finding Lab Growth Opportunities Amid the Gloom

IN MANY WAYS, THE TRADITIONAL BUSINESS MODELS for laboratory testing services are proving deficient in the face of a swiftly-evolving healthcare system. I suspect that none of us fully understand how many laboratory organizations are already under extreme financial stress. We intuitively understand …

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2012’s Top Ten Lab Stories Predict More Challenges

CEO SUMMARY: It’s been a year with more lows than highs, when viewed through the lens of THE DARK REPORT’S “Top Ten Lab Stories of 2012.” The end of the TC grandfather clause, new policies for prostate biopsy billing, and a dramatic 52% cut to 88305- TC fees were widely reported. …

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RDX Alters Business Plan Due to Lab Market Changes

CEO SUMMARY: Executives at Regional Diagnostic Laboratories (RDX) made a splash last May when they announced the new company’s plans to acquire hospital laboratory outreach programs, backed by a capital commitment of $250 million. Now, in recognition of swift changes in the lab test mar…

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