TAG:

Medicare Administrative Contractor

What Labs Can Expect from PAMA in 2019

CEO SUMMARY: Attendees at the Executive War College learned that CMS has taken steps to expand the number of hospital labs required to report their private payer lab test price data under the Protecting Access to Medicare Act, but the unbundling of certain test panels could be problematic…

Read More



California Lab Company Closes After Negative Medicare Decision

WITH EACH NEW RULING about coverage for a proprietary diagnostic assay, Medicare officials send a message to the entire clinical laboratory industry that any lab company with a proprietary test needs to submit adequate clinical evidence that demonstrates two positive aspects of the test. First, that…

Read More



August 7, 2017 Intelligence: Late Breaking Lab News

PAML of Spokane, Washington, was the subject of an unusual public disclosure recently made by Laboratory Corporation of America. The lab company sent a statement to the Spokane Journal of Business stating its plans to make PAML “its primary lab site in the western…

Read More



July 17, 2017 Intelligence: Late Breaking Lab News

Here’s an update on Theranos, the troubled lab company that is struggling to stay alive. Once again, reporter John Carreyrou of The Wall Street Journal scooped his peers by reporting that Theranos has listed its corporate offices for lease. For lab companies shopping for …

Read More



June 26, 2017 Intelligence: Late Breaking Lab News

Theranos is back in the news again. The Wall Street Journal reported earlier this month that the troubled lab company is close to negotiating a settlement with Walgreens after being sued for $140 million in a breach of contract lawsuit filed by the national pharmacy…

Read More



Medicare Demands Force PGx Lab into Bankruptcy

CEO SUMMARY: It’s becoming a familiar story. In Houston, a pharmacogenomics lab company started strong in 2011, then payments dropped sharply when Medicare issued restrictive new guidelines for PGx testing. Next, the Medicare administrative contractor handling the claims of CompanionDx …

Read More



Another Pharmacogenomic Lab Hit With Audit, Multi-million Dollar Repayment Demand

CEO SUMMARY: In 2014, during a ZPIC audit of an unnamed pharmacogenomic testing lab, a federal auditor reviewed a small number of claims that had been filed over a period of several years. Despite supporting letters from physicians, the auditor rejected those claims, then extrapolated the…

Read More



$26 Million Recoupment from Medicare Audit Hammers Pharmacogenomic Lab

CEO SUMMARY: After Pharmacogenetics Diagnostic Laboratory LLC was audited by a Medicare Zone Program Integrity Contractor (ZPIC), it faced a $26 million repayment demand. The lab company appealed and asked for a redetermination, then filed for Chapter 11 bankruptcy protection. These devel…

Read More



Pharmacogenomic Testing Draws $26 Million Recoupment from Medicare Audit

This is an excerpt from a 1,340-word article in the January 9 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. CEO SUMMARY: Phar…

Read More



Genetic Testing Lab Finds Payers Respond To Education on Test Utility

CEO SUMMARY: In recent years, insurers have raised the bar and become much tougher when making coverage and reimbursement decisions for molecular assays, genomic, and genetic tests. Yet several lab testing companies are having good success at demonstrating the validity and clinical utilit…

Read More



How Much Laboratory Business Intelligence Have You Missed?

Lab leaders rely on THE DARK REPORT for actionable intelligence on important developments in the business of laboratory testing. Maximize the money you make-and the money you keep! Best of all, it is released every three weeks!

Need A Group Membership? Company Discounts are Available!

Sign up for TDR Insider

Join the Dark Intelligence Group FREE and get TDR Insider FREE!
Never miss a single update on the issues that matter to you and your business.

Powered by Americaneagle.com

Hosted by Americaneagle.com, Inc.