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managed care organization

LabCorp Exec Discusses Reasons Behind Its 10-Year Pact with United

“This 10-year agreement is unique in the laboratory industry. It speaks to the long-term commitment of both parties.”—Brad Smith, Executive Vice President, Laboratory Corporation of America CEO SUMMARY: It was unprecedented when UnitedHealth …

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Three Ex-UroCor Execs Acquitted in Jury Trial

CEO SUMMARY: On June 30, 2006,three former executives of UroCor,Inc.,accused by the U.S. Attorney of anti-kickback and securities violations, stood and heard the jury verdict in their case. “Not guilty on all counts,” stated the jury foreman. Thus ended the effort to convict former ex…

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Payer Consolidation: WellPoint Buys into NYC

CEO SUMMARY: Acquisition by acquisition, the health insurance industry is consolidating. Wellpoint, Inc., already the nation’s largest health insurer at 28 million members, is acquiring WellChoice, Inc. and adding another 5 million members to its total. One consequence of this consolida…

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How Local Path Groups Can Keep Patient Access

CEO SUMMARY: For pathology groups operating their own histology and cytology labs, a growing problem is access to patients covered by exclusive managed care contracts. In the Northeast, several persistent pathology group practices are using some effective business strategies to fight this…

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UroCor’s Sales Tactics Violated Medicare Laws

CEO SUMMARY: By issuing a multi-count criminal indictment against three former UroCor executives, one federal attorney is creating new legal precedents for the laboratory industry. The criminal charges accuse UroCor of inducing physicians through such gambits as deeply-discounted pricing …

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OIG Moves to Address “Usual Charge” Issue

CEO SUMMARY: Federal regulators are taking another crack at defining “usual charges.” Language in the proposed rules published last month precisely defines which payers should be included in determining “usual charges” and what charge basis to use for specific payers. Once effecti…

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LabCorp’s MacMahon Provides Insights About Lab Marketplace

CEO SUMMARY: Pathologists will be particularly interested in what Thomas MacMahon has to say about the evolution of laboratory medicine. As Chairman, President, and CEO of Laboratory Corporation of America Holdings, he has continuous access to some of the best strategic analysis about the…

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SBCL Makes System-Wide Commitment To AutoPap

SOMEONE ALWAYS HAS TO BE FIRST to adopt new technology. In the case of automated cytology, it will be SmithKline Beecham Clinical Laboratories (SBCL). SBCL and NeoPath, Inc. announced a four-year national agreement between the two companies on October 9 which will e…

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Blunt Talk From HMO Blue’s Ancillary Contracts Manager

CEO SUMMARY: By now, most clinical laboratory executives and pathologists have discovered a new fact of life: provider status with managed care organizations is a critical success factor. Without provider status, the laboratory is denied access to patients and the reimbursement associated…

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Tennessee Lab Network In Start-Up Preparations

CEO SUMMARY: Planning for the Middle Tennessee Healthcare Network’s proposed regional laboratory network took longer than expected, but not without good cause. Organizers of this laboratory network did their homework and created a solid business plan. Approval by CEOs from the participa…

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