TAG:
managed care contract
Hospitals Recognize Need for Uniform Lab Test Data
CEO SUMMARY: Hospitals may soon insist that payers allow their in-house labs to provide outpatient testing regardless of exclusive managed care contracts with national lab companies. The migration to accountable care organizations (ACOs) and medical homes makes it essential that physician…
Health Insurers See Big Increase in Lab Utilization
CEO SUMMARY: In a recent public workshop, managed care executives revealed that the annual cost of outpatient laboratory testing is increasing at twice the rate of all other medical services. One big driver in the increased spending on lab testing is increased utilization…
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….
Preserving Competition Is Goal of California Lawsuit
CEO SUMMARY: Once again, the use of deeply-discounted lab test pricing to win exclusive managed care contracts is involved in a court case. However, this latest private lawsuit is different from earlier cases because it seeks to preserve competition in the lab testing and the managed care…
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. …
Four California Labs Sue Quest and Three Insurers
CEO SUMMARY: Allegations of anticompetitive and monopolistic behaviors that violate state and federal laws are the basis of a private lawsuit filed by four independent clinical lab companies in California. The defendants are Quest Diagnostics Incorporated, Aetna, Blue Shield of California…
OURLab Founder Lays Out New Business Strategy
CEO SUMMARY: For OURLabs of Nashville, Tennessee, it was the host of changes in the lab testing marketplace that motivated it to go looking for a partner. Its recently-announced merger with OPKO Health, Inc., of Miami, Florida, creates opportunities for OURLab pathologists to do more in t…
Lab Director Blows Whistle, NY Closes Hospital Lab
CEO SUMMARY: Unable to overcome problems at a rural hospital laboratory caused by the parent hospital’s financial problems and the inability of the hospital to recruit adequate numbers of lab staff, the laboratory director terminated his agreement with the hospital and notified the New …
New BlueCard Policies Affect Lab Test Claims
CEO SUMMARY: This new policy from the Blue Cross and Blue Shield Association (BCBSA) becomes effective on October 14, 2012. No longer can a local lab provide service to a member under the BlueCard program and be paid by the local plan in the region where the service was provided….
Employers, Payers Are Challenging ‘High’ Test Prices
ONE NATIONAL TREND IN CLINICAL LABORATORY TESTING that has not yet gotten wide play outside the pages of THE DARK REPORT is the emergence of what might be termed a “war” by national and regional health insurers against the “higher” prices often charged by hospital laboratories. This is a key…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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