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Palmetto Execs Explain Molecular Test Policies

CEO SUMMARY: To create more transparency in the process clinical labs use to submit claims for genetic tests, molecular diagnostic tests, and for laboratory-developed tests (LDT), the nation’s largest Medicare Administrative Contractor (MAC) has proposed two new local coverage determina…

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Palmetto GBA Announces Molecular Test Registry

CEO SUMMARY: Palmetto GBA, the nation’s largest Medicare Administrative Contractor (MAC), is asking labs in the J1 jurisdiction to submit applications for each molecular test they run. Molecular assays will receive a unique five-digit alpha-numeric identifier (Z-code) that will be enter…

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Economics of Lab Testing to Be Challenged

BY ANY MEASURE, 2012 IS SHAPING UP TO BE A YEAR OF MAJOR CHANGE for healthcare and the clinical laboratory testing industry. Unfortunately, an early reading of the tea leaves indicates that the outcomes are not likely to be favorable for most clinical laboratories and anatomic pathology groups. Letâ…

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Medicare Carrier Plans to Reject Molecular Claims

CEO SUMMARY: In September, Palmetto, a Medicare carrier serving California and seven other states, made public two draft local coverage determinations (LCDs) that revamp its coverage guidelines for molecular diagnostic tests (MDT) and laboratory-developed tests (LDT). All labs su…

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Congress Likely to Pass Deep Cuts in Lab Test Fees

CEO SUMMARY: All signs point to a potentially dismal financial outcome for the clinical lab testing industry as Congress tries to trim spending by $1.2 trillion over the next 10 years. At least three proposals to significantly cut lab test reimbursement are in active debate by fe…

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Teamsters, UCFW Sue NID, Quest In Racketeering Case

CEO SUMMARY: For the second time in recent years, Quest Diagnostics Incorporated and Nichols Institute Diagnostics (NID) face a lawsuit alleging problems with a number of diagnostic test kits that were manufactured and sold by NID going back to 2000. The plaintiffs are two unions…

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Key Legal, Compliance Issues for Labs Identified

CEO SUMMARY: It’s a first in the lab industry. In recent weeks, THE DARK REPORT asked the nation’s leading attorneys in clinical lab and anatomic pathology law to identify the most important legal, compliance and managed care issues for 2011 and 2012. Using a consensus method…

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Lawyers Provide Insights About Top Legal Concerns

CEO SUMMARY: After conducting the first-ever survey of the most important legal, compliance and managed care concerns for clinical labs and pathology groups, THE DARK REPORT asked leading lab industry attorneys who participated in the survey to say a few words about these topics….

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Reading the Tea Leaves from 2010’s Events

EACH YEAR WHEN WE PRESENT OUR “Top Ten Lab Stories†for the year, I am always surprised at which forces for change emerged during the prior 12 months. In presenting THE DARK REPORT’S “Top Ten Lab Stories for 2010,†our editor has pointed out that four of these ten stories involved the feder…

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Our Top Ten Lab Stories Highlight Major Changes

CEO SUMMARY: What makes 2010 a watershed year for the laboratory testing industry is enactment of the 2,700-page Patient Protection and Affordable Care Act (PPACA). Even if parts of this bill are repealed, the remaining parts of the massive legislation will trigger major changes …

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