TAG:
managed care plan
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 …
Lawyer Argues: UroCor Charges Are a Concern
CEO SUMMARY: Criminal charges in the case against three ex-UroCor executives will likely alter existing compliance practices that affect how a lab offers price discounts to physicians and the way a lab uses “waiver of charges” in situations where it is an out-of-network provider. Atto…
New Healthcare Change Cycle Is Opportunity to Fix Problems
CEO SUMMARY: Healthcare’s new cycle of change will be greatly influenced by geneomics, proteomics, the Internet, consumer-driven healthcare, and political decisions that affect the Medicare and Medicaid programs. The launch of a such a new cycle of change presents the laboratory industr…
Catholic Hospital in Illinois Loses Tax-Exempt Status
HOW HOSPITALS BILL and collect from uninsured patients is becoming a national issue. The latest shot fired is a ruling by the Illinois Department of Revenue revoking the state property tax exemption of Provena Covenant Medical Center, located in Urbana, Illinois. Th…
Price Discount Practices May Prove Troublesome
CEO SUMMARY: Some laboratories continue to offer deeply-discounted prices to the nation’s largest managed care plans as a way to maintain provider status and keep market share. In one case, these deep discounts surprised a long-time lab executive, who decided to share the information, a…
“New” Legal Landmines For Clinical Laboratories
CEO SUMMARY: HIPAA is a big “new” source of legal expo- sure for laboratories and other healthcare providers. Also, recent court decisions and changes in clinical practices are adding to the legal risk for labs. Attorney Richard S. Cooper offers insights on how laboratories can better…
“Waiver of Charges”: What Makes It Work
CEO SUMMARY: Little-used in the 1990s, when laboratory test ordering and billing practices were under intense scrutiny by federal regulators, the strategy of “free testing” is popping up in more regions around the country. To comply with compliance guidelines, labs using this strategy g…
“Free Testing” Strategy Stirs the Pot in Tenn.
CEO SUMMARY: In Tennessee, the state’s Medicaid HMO plan has been at odds with Quest Diagnostics Incorporated, which is using the “free testing” strategy to expand its share of the market. In recent months, TennCare Select has taken active steps to insure its physicians understand tha…
Where Will “Free Tests” Take the Lab Industry?
CEO SUMMARY: In the absence of public discussion, continued use of the “free testing” strategy by the nation’s more aggressive laboratory companies could trigger some unpleasant consequences that would affect all laboratories and pathology group practices. Five questions, presented he…
Laboratories Sit Squarely Between New Genetics and Today’s Medicine
“Clinical laboratories and pathology groups are at the leading edge of the genetic revolution.” —Rick J. Carlson. CEO SUMMARY: Healthcare futurist Rick J. Carlson believes that knowledge of the human genome will trigger revolutionary…
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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