Tag: managed care plan

Nine Lab Groups Say New NCCI Policy Is Inconsistent

CEO SUMMARY: By its name alone, the National Correct Coding Initiative (NCCI) Policy Manual implies that it will be accurate and consistent with other coding initiatives. But nine groups representing various clinical laboratories say NCCI guidelines that the federal Centers for Medicare and Medicaid Services issued in December and implemented on Jan. 1 are inconsistent

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Florida Legislators to Hold Hearing on Bill About Payer Use of Decision Support for Lab Orders

CEO SUMMARY: Physicians in Florida and their state medical associations continue to battle UnitedHealth over its laboratory benefit management program that uses the lab test ordering system by BeaconLBS, a business unit of LabCorp. The latest round in this fight is language in a Florida Senate bill that would prohibit the use of a “clinical

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State of Clinical Lab Industry Likely to Be Mixed in 2016

CEO SUMMARY: Over the next 24 months, it will be essential for every clinical laboratory and anatomic pathology group to develop clinical and financial strategies that meet the changing needs of health insurers, hospitals and health systems, physicians, and patients. THE DARK REPORT provides its assessment of key macro trends for 2016, along with comments

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More AP Consolidation: Aurora Buys Two Groups

Aurora, BVP

CEO SUMMARY: Seeing the changes overtaking pathology practices, Brazos Valley Pathology decided to sell two of its group practices to Aurora Diagnostics. Last month’s transaction was not designed to fix financial problems nor was it because of retiring pathologists. Rather, it was done proactively to ensure that BVP’s 11 pathologists had access to the resources of a larger pathology organization so that they could expand or add technology as needed in the future, while practicing independently.

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Locked Out of Payer Network, NH Hospital Opens Lab Company

CEO SUMMARY: Since Anthem launched its site of service program in New Hampshire in 2010, labs in the state’s hospitals have mostly been excluded from its network and have lost market share. Recently one community hospital developed an unusual strategy to win back those patients. Last year, Frisbie Memorial Hospital in Rochester, opened a stand-alone independent lab company that became a provider in the Anthem network. To date, the independent lab has been gaining patients steadily, hospital officials say.

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