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CMS physician fee schedule: Will hospital labs be excluded again from PAMA price reporting?

CEO SUMMARY: Publication of the draft CMS Physician Fee Schedule on July 12 brought unwelcome news for the clinical lab industry, at least as it pertains to that perennial question: Should hospital lab outreach data be included in a PAMA market study? The federal Centers for Medicare and …

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Rural Hospital Group Says Lab Billing Model Is Legal

CEO SUMMARY: In recent years, many rural hospitals have entered into agreements to expand their laboratory outreach businesses. In an interview, the president of the National Association of Rural Hospitals said rural hospitals often bill for lab outreach services under Medicare’s 70/30 …

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Rural Hospital Spokesman: Hospital Lab Outreach Programs Are Legal

CEO SUMMARY: As the debate grows more heated, supporters of hospital outpatient department (HOPD) billing schemes have ramped up their defense of the practice. The president of the National Association of Rural Hospitals tells THE DARK REPORT that rural hospitals…

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Theranos News Gets Worse for the Former Silicon Valley Hero

CEO SUMMARY: In a tale of two fraudsters, the Department of Justice has filed a warning shot to all technology startups: Criminal indictments against Elizabeth Holmes and Ramesh “Sunny” Balwani could mean prison time and massive fines. In this latest Theranos news, The DOJ ci…

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Holmes, Balwani Indicted by Department of Justice

CEO SUMMARY: Federal criminal indictments were unsealed last Friday in San Francisco against Elizabeth Holmes and Ramesh “Sunny” Balwani for their actions as executives at Theranos, Inc., the once high-flying lab test company. Officials at the Department of Justice said the counts aga…

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Hospital Lab Outreach Still Effective Revenue Strategy

CEO SUMMARY: Despite the challenges hospital and health system laboratory outreach programs face today, there are many ways they can remain viable, according to an outreach expert from Mayo Medical Laboratories. By taking specific steps to increase volume and the value they provide, lab o…

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Myriad to Buy Counsyl, to Gain Presence in NIPS Test Sector

LATE LAST MONTH, Myriad Genetics Inc. announced a definitive agreement to acquire Counsyl, Inc., an innovative genetic testing company in South San Francisco, Calif., for $375 million. In a deal that is expected to close by early next year, Myriad will use a combinat…

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May 29, 2018 Intelligence: Late Breaking Lab News

Ireland is dealing with a cervical cancer screening scandal that reaches back to laboratories in the United States. In recent months, the Irish public has learned that more than 200 women wrongly got negative Pap test results over a multi-year period. Many of these women did not learn of the erroneo…

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How Many Patients Were Harmed at Theranos?

CEO SUMMARY: Reporting in The Wall Street Journal shows that some physicians in Arizona were concerned about the harm from erroneous test results from Theranos Inc. But those physicians who expressed concern may have been only a small set of the …

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Insurers Sue To Challenge Pass-Through Bill Schemes

CEO SUMMARY: In two separate lawsuits filed in April, UnitedHealthcare (UHC) and Anthem each charged that drug testing companies used pass-through-billing schemes in ways the insurers say are fraudulent. UHC filed its lawsuit on April 18. One day later, on April 19, Blue Cross and Blue Sh…

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