TAG:
managed care
BRLI-Horizon BCBS Lawsuit Is Window to Payer Actions
CEO SUMMARY: Do “actions speak louder than words?” In New Jersey, one lab company sued a major health insurer for “breach of contract and fraud.” Court documents include claims describing how one health insurer became ever more sophisticated in how it played one public lab company…
Pathology Consolidation Underway in Washington
CEO SUMMARY: Two regional pathology super-practices have emerged in Washington State. In each case, acquisitions and mergers are fueling the growth of the two large pathology groups. In Western Washington and the Seattle metro, CellNetix is the dominant pathology group, with 53 physicians…
Pathologists Top Earners in Medicare MD Pay Data
CEO SUMMARY: Never in 50 years had the Medicare program made public the money it pays physicians for Part B services— never until April 9, that is. On that day CMS revealed how it disbursed $77 billion to individual physicians during 2012. Newspapers and television reporters jumped on t…
Lab Serving Large MD Group Manages Quality and Costs
CEO SUMMARY: For decades, pathologists have pointed out that their expertise in laboratory medicine can be tapped by physicians to improve utilization of lab tests, contribute to improved patient outcomes, and reduce the overall cost of care. Exactly that is now happening at Atrius Heal…
New Federal Law Changes How CMS Sets Lab Prices
CEO SUMMARY: CMS wanted more power to cut the prices it pays for clinical lab testing. A significant part of the lab industry wanted more transparency and consistency in how CMS established coverage guidelines and prices for new lab tests. Congress appears to have attempted to craft a law…
Maine’s Spectrum Medical Group Offers Multiple Specialties
CEO SUMMARY: Pathologists looking for a viable future in a healthcare system marked by integration of clinical care and value-based reimbursement will be interested to learn about Spectrum Medical Group based in Portland, Maine. This 180-member multispecialist group includes 22 pathologis…
Federal Judge Lets Trial Proceed in Case against Quest
CEO SUMMARY: Four California labs have charged that Quest Diagnostics engaged in predatory pricing in a case filed originally in November 2012. After the lawsuit was amended last summer and fall, U.S. District Judge William H. Orrick III heard various motions in the case. On February 6 he…
Labs, Path Groups Face Major Financial Issues
CEO SUMMARY: Are clinical labs and pathology groups ready for the end of fee-for-service reimbursement? That’s just one important question that will be answered at the upcoming Executive War College on Lab and Pathology Management that will take place in New Orleans on April 29-30. The …
Scrutinizing the Cost of Lab Testing
IT SEEMS LIKE THE COST OF LABORATORY TESTING continues to be a high-profile issue. On the pages that follow, you will read two different stories about how the cost of lab testing is undergoing intense scrutiny. This is not an accident. Rather, it shows how healthcare’s evolution is already undermin…
February 24, 2014 “Intelligence: Late Breaking Lab News”
Maybe the tough financial environment here in the United States is causing Sonic Healthcare Ltd., one of this nation’s bigger lab players, to be more interested in overseas lab testing opportunities. On February 18, its CEO, Colin Goldschmidt, M.D., told investors that “We contin…
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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