TAG:
Medicare Advantage
Labs, Payers Don’t Like Prior Authorization for Genetic Tests
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How Private Health Insurers May Respond to FDA LDT Regulation
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UnitedHealth Group Faces DOJ Antitrust Probe
CEO SUMMARY: Recent events have not been kind to UnitedHealth Group and its subsidiaries UnitedHealthcare and Optum. In February, just as UHG’s Change Healthcare division was hit with a major cyberattack that disrupted billions of dolla…
Payer Contracts with Labs: Getting the Contract Is Just the Start
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CMS Issues AI Guidance for Medicare Advantage
CEO SUMMARY: With its guidance on how Medicare Advantage plans should use artificial intelligence (AI) when making treatment decisions involving individual patients, the federal Centers for Medicare and Medicaid Services has opened one door in the coming debate on how the federal governme…
Lab Data Crucial to Insurer Risk Adjustment Models
CEO SUMMARY: Payers who use risk adjustment models as part of Medicare Advantage need diagnostic data that helps them document ICD-10 diagnoses that earn them higher premium payments for sicker pat…
Private Health Insurers Are Aware of Problems with CPT Code 81408
EDITOR’S NO…
Lab News Briefs: Joint Commission, Bon Secours, Anthem, Walmart
Joint Commission Looks at Cyberattacks The Joint Commission issued a Sentinel Event Alert for hospitals to address cyberattacks. The alert pr…
Big Employers Sue Payers over Price Transparency
CEO SUMMARY: Feeling they’ve been denied access by insurance companies to price data about medical claim payments, self-funded employer plans and unions are taking their health insurance companies…
Smaller Labs Must Verify Z-code Arrangement with Lab Companies
EDITOR’S NO…
CURRENT ISSUE
Volume XXXI, No. 10 – July 22, 2024
An attorney widely experienced in clinical laboratory regulation has prepared guidelines for complying with the FDA’s new LDT rule, and The Dark Report offers them in their entirety to readers. Also, a House of Representatives bill includes language calling for the FDA to suspend its rule.
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