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Whole Genome Sequencing Is Poised for Clinical Use

CEO SUMMARY: Pathologists and clinical lab managers interested in following the advances in use of whole human genome sequencing for clinical purposes should follow the money. Within weeks of obtaining FDA clearance for its MiSeqDx system and reagents, Illumina had inked major agreements …

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Tricare, DOD Not Paying for MoPath Codes, LDTs

CEO SUMMARY: It turns out that labs serving Tricare patients are going unpaid for certain LDTs, molecular, and genetic tests. The issue of nonpayment began in January 2013 when Tricare stopped paying for these tests that were billed under the new molecular CPT codes that replaced the prev…

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CMS Proposes Yet More Cuts for 2014, Beyond

CEO SUMMARY: In July, CMS proposed rules to cut payments under the Hospital Outpatient Prospective Payment System, the Physician Fee Schedule, and the Clinical Laboratory Fee Schedule. Under each program, the proposed payment cuts could have a significant and negative effect on the amount…

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July 08, 2013 “Intelligence: Late Breaking Lab News”

In China, independent clinical laboratories are in a fast-growth mode. That’s the conclusion of RnRMarketResearch in a newly-issued survey of the clinical laboratory testing market in China. It estimates this market segment at US$407 million annually. RnR says that three lab companies meet …

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Labs Have New Hurdles as Some Payments Start

CEO SUMMARY: Some payments are beginning to flow for claims submitted under the new molecular test CPT codes. But there is a new issue. Medicare contractors, Medicaid programs, and private health insurers are deeming certain molecular tests to be medically unnecessary. Th…

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Why One Molecular Diagnostics Company Closed Its Doors

CEO SUMMARY: When executives closed the doors of Pathwork Diagnostics last month, the simple explanation was that reimbursement for its proprietary molecular diagnostic test was inadequate. Indeed, that was part of the story. But other factors played significant roles in impeding…

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Four Labs and Billing Company Pay $140,000 Fine in HIPAA Case

WHEN A BILLING SERVICE company disposes of patients’ lab test records, it should do so in compliance with federal and state privacy rules. That means all protected health information (PHI) should be shredded or incinerated. Four pathology groups in Massachusetts learned this lesson the hard way wh…

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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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First-Mover Labs Reveal Success with Lean & QMS

CEO SUMMARY: There is good news for those clinical labs and pathology groups currently operating robust Lean, Six Sigma, and process improvement programs. The Institute of Medicine’s new report calls for all healthcare providers to rapidly transform themselves into ‘continuously learn…

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ACLA Has its Say Regarding Molecular Dx Proposals

CEO SUMMARY: It is not known how many public comments have been submitted to Palmetto GBA, the big Medicare carrier, in response to its published proposals to change how code stacked claims for genetic and molecular tests will be handled, effective February 27, 2012, for labs in Medicare …

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